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tts after fracture...new here

Posted by Kari B on 10/28/02 at 18:02 (098510)

Hi all,
I have been reading this message board for about a week now so that I could try to gain some insight into this disease my dr is telling me I have. A little history: June 12,2002 I fractured my foot in 2 different places (forgive me when I say I don't remember what bones they were, but I dont... I just know they are located near the arch of my foot and are little bones) I went to an ortho and was casted for 3 weeks and then placed in a fracture boot. To this day I still have severe pain but somewhere along the way of recovery from the fracture the pain started to change. It eventually started burning, tingling etc. I had some symptoms of the nerve being inflamed from about week 3 and the Dr put me on oral steroids with the hope of helping this. As time went along, the pain was not localizing and the pains weren't the 'slap in the face, nervy type pains' so he was having some difficulty dx'ing my continued pain. He sent me for every test imaginable I believe and during that time my foot definitely began feeling like nerve pains... the typical (or what appears here as typical) tingling, numbness, dull ache, burning or feeling of being very very cold even when it wasn't cold. I went back for all the results and all the signs point to the nerve so my Dr gave me an injection into the nerve which gave me great relief for about 3 days and once again (day 7) hurts so badly I cant sleep, cant stand up, etc. I saw ortho today and he has given me the option to have the surgery done, which would include going in and removing the scar tissue that shows on the mri and which he feels has been caused by the fracture. He's a very good ortho surgeon and I trust him completely (after lots of personal recomendations from other people in our little town) and feel that he would not recommend something if he believed it could be more damaging to me than what I am already going through. Ok, so for my questions: My main question is if there is anyone on this board who has a definite diagnosis of tts due to a fracture or trauma injury? If so, have you had surgery, what treatments etc? To anyone: From what I have seen here, this surgery appears to be risky--- is it any less risk with having it done for something that has shown up on mri, definite tissue build up around the suspect area.... or is it just as risky? P.S. we have tried anti-inflammatories of course, pain meds, and under this orthos care since I broke my foot in June. Does anyone have any suggestions, advice .... I'm listening! Thanks and hope everyone is as pain free as possible.
Kari in California

Re: tts after fracture...new here

elliott on 10/28/02 at 18:20 (098512)

Hi, Kari! Sorry for your troubles. Sounds like you're contemplating a TTS release (I had it done in both feet.) The surgery releases the nerve by cutting away a band of tissue to give it more room to move. In your case, it might also entail scraping away bone or some such (did your surgeon discuss that with you? I presume you had an xray). It is my understanding that when TTS results from something like a fracture, it is less likely to go away by itself since something has moved out of place to interfere with the nerve, so a decision as to surgery may be easier. The consensus is that if an MRI shows something that is likely to be causing your problems and that will be addressed at surgery, your chances are better. Of course, success rates for TTS surgery are a bit lower than for most; results are sometimes unpredictable. In the case of fracture, there is always the possibility that permanent damage has been done to the nerve. But the wife of a podiatrist I used who got TTS from a fractured ankle had the TTS release and recovered 100%. Good luck.

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Re: tts after fracture...new here

Kari B on 10/29/02 at 01:07 (098524)

Elliot,
Thank you for those encouraging words... I think that is what I was looking for to feel better after reading about all the failed tts releases. My Dr has explained that there could be more in there than what we have seen on the MRI... he also did bone scans, a gallium scan, etc. I'm glad he didn't just dive headfirst into the idea of surgery and has done everything that I have been reading about before contemplating this idea. It does make me feel safer knowing that he obviously is aware of the treatments and alternatives BEFORE surgery as I had a neurosurgeon a few years back remove 90% of my L4-L5 disc that was sitting on the S1 nerve but never told me there were options... go figure... he told me about the steroid shots and epidurals AFTER he did all the cutting and it didn't get rid of all my back pain. Luckily after several years of PT and watching what and how I do things I have finally reached about 95% relief from pain. LOL... and now this! Well, I'm hoping that the surgery will relieve the pain but I am not expecting immediate relief. Doc has stated that it could take anywhere from immediately to a year (depending on how my body heals, and especially being a nerve) for me to see complete relief. He has also made me aware that the possibility for permanent damage from the bone fracture is something I could be facing as well. I feel comfortable that he has been keeping me informed as to all options, risks, and possibles that can happen. Anyway, I want to thank you for responding, I have gained quite a bit of information from posts on this board, it's been a life saver!
Kari

Re: tts after fracture...new here

elliott on 10/29/02 at 08:09 (098534)

I also have the L4-L5 thing, lower back/butt/hamstring irritation on right side, now over 3 1/2 years, starting around the time of my first TTS surgery. The back was so bad back then that I was close to surgery despite my reservations and fears but got lucky finding out about epidurals, etc. Got an epiduroscopy (scope-guided epidural) this past March I think it was, and that brought the pain level permenently down a chunk, as has yoga, other exercise, hanging on an inversion sling, occasional Aleve (Celebrex and Vioxx did nothing) and the passage of time. I'm past the stage of risking the full disc surgery, but after travelling to N.J. last week, 3 hours each way all in one day (youch!), I realize I still have quite a ways to go. It's been a long time and I'm weary. Do you have anything to add by way of advice? Thanks!

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Re: tts after fracture...new here

Kari B on 10/29/02 at 11:13 (098551)

Hi Elliot,
Sounds like you've got things well under control, although, when you travel you need to remember to stop at least once an hour for 30 minutes and do some of you stretching exercises if its possible. Also, something my husband got me was a chair pad which plugs into the cigarette lighter in my truck and it has vibration (light, medium, or high) and you can also have heat with it too. When I'm traveling anywhere, that is a God send!!! That way I'm still recieving the input from the vibrations and I go back and forth with the heat, say... 10 minutes with heat on, 30 minutes with heat off.../ whatever feels the most comfortable. You can find these at any drugstore/medical supply store... even Wal-mart carries them if you can find them quickly. And, they are NOT expensive!!
I was given sets of stretching exercises to do by my PT before I even get out of bed and I do them every morning... it really does start my day off right. Although with doing the yoga and all, it definitely sounds like you are on the right track, just dont overdo it!! I know this probably sounds stupid too, but I very rarely lift anything over 15 lbs, I try to stay away from any activity that requires me to bend repetively. When I do bend to pick up something, I rely more on my legs than my back and that was sooooooooooo hard for me to learn how to do. If you have any other questions or suggestions for me, I'm here!! Good luck to you... I feel you are a very strong person having been able to make it through all this with your back without falling into surgery... I just wanted them to cut my leg off and get it overwith LOL! Hugs to ya,
Kari

Re: tts after fracture...new here

elliott on 10/29/02 at 13:24 (098567)

Kari:

I think the reason I held out at that time getting my back operated on was that my feet were having post-surgical trouble!

There's no way I can spend half my travel time at rest stops doing stretching; popping an Aleve on those occasions helps, as long as my stomach can deal with the explosives.

Thanks for the tip on the seat. In case I have trouble locating it, do you have a brand name or something to go on? Thanks.

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Re: tts after fracture...new here

Kari B on 10/29/02 at 17:23 (098600)

Yes, its by the brand name of Homemedics.... they also make other types of back supports, shower stall handles, knee braces, just about anything someone could need for health. I'm not sure, but they may have a website, I have never thought to check. Good luck (I like Aleve as well when I cant take anything stronger)

Re: tts after fracture...new here

Melanie E on 10/29/02 at 19:57 (098609)

I am glad to have found this site and to read these messages. I broke the talor dome bone in the ankle and had spontaneous neucrosis. I was on crutches for 2 months. Now I have tarsal tunnel syndrome and was told my choices are to live with it or have surgery. I am having another MRI this week to see if the bone that died is growing back. If it hasn't then surgery will be needed anyway to drill holes in the bone to stimulate growth so I would then have the nerve released at the same time. I still limp and the pain is very constant. I haven't missed a day of work but as my tolerance goes down from the pain I am considering sriously having the surgery. How long after surgery were you on crutches? Did they cut the nerve or just clean out scar tissue? thanks

Re: tts after fracture...new here

elliott on 10/29/02 at 21:17 (098619)

Kari, I'll check it out. Thanks!

Re: tts after fracture...new here

Kari B on 10/29/02 at 21:17 (098620)

Melanie,
I haven't had the surgery yet. We are waiting for the authorization from insurance and then the dr will give me a call to let me know when its scheduled for. Most likely I will be having it done next week, so I will post updates here as much as possible afterwards. I'm sorry to hear you've been in so much pain... I like you have not had any relief in pain since I fractured my foot. According to my Dr, he plans to go in and clean out the scar tissue that has built up from the fracture and put some kind of medication into the nerve to keep it from getting infected or any more inflamed. He will check to make sure there is nothing else going on that hasnt shown up on all of the tests he's done and then close it up. He told me that when I wake up, I will have a fairly large soft cloth type of cast on it for the 1st week and then I will be going back into my boot for awhile... at the minimum of 3 weeks. He's said that it takes quite a bit of time to heal from this type of surgery and to just plan to take my time and only do what feels comfortable to me. I will also be back on non-weight bearing restriction and crutches for at least the first 4 weeks. This all I basically know right now, but if I have my surgery before you, I will definitely report here what/how things go. Good luck to you and keep me updated on yourself as well! Take care!
Kari

Re: tts after fracture...new here

Kari B on 10/29/02 at 21:30 (098622)

Elliot,
I found one online at walmart.com if you want to check it out... the one I have has the AC and 12 volt adapters for home or vehicle use. I'm not sure if posting links here works or not, but here goes

http://www.walmart.com/catalog/product.gsp?cat=36290&dept=4044&product_id=1926340&path=0%3A4044%3A36290%3A77957%3A4571

I hope it works for you!
Kari

Re: tts after fracture...new here

Melanie E on 10/29/02 at 21:48 (098625)

Kari, thanks for your response. Egad, next week huh? You definitely will be ahead of me as I won't have the surgery until December. In the meantime I will grit my teeth and limp. If the bone (talor dome in the heel) is growing back, then I am crossing my fingers unrealistically that the pain will go away and I wont need surgery. If the bone isn't growing back, then holes would have to be drilled in the heel and I would have the tarsal tunnel dealt with at the same time. I just put those dang crutches away and am not ready to submit to being on non-weight bearing again. It was very difficult carrying anything and I had to use a packback. I am coming to the brillant conclusion that this is a long haul to recovery. I am relieved to find out what it is though. I was getting very nervous about the leg getting so cold, the shooting pain in the heel and up the leg and the numbness. thanks again, Melanie

Re: tts after fracture...new here

elliott on 10/29/02 at 22:17 (098630)

Melanie, did you get checked for RSD (CRPS)?

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Re: tts after fracture...new here

Kari B on 10/29/02 at 22:19 (098631)

Melanie,
Do you mind me asking how old you are? I kept thinking that my foot wasnt healing right or something because of my age lol... I'm 31 (but with 3 kids!) When I mentioned that to my orthoped, he laughed so hard, luckily he has a good humor. Anyway, the avascular necrosis is something he thought might be going on, but the gallium scan didn't show any cold spots and it hasnt been detected on MRI or x-ray... so I'm praying thats not whats going on with it too. I agree Totally with you about the crutches, I couldn't wait to toss those things and now I have to use them again and I think I'm actually dreading that more than the surgery itself!
Kari

Re: tts after fracture...new here

elliott on 10/29/02 at 22:22 (098632)

Thanks!! I might just buy it! But you sure this thing works? I'm starting to feel like I'm Carmen H; she tries everything. :-) Just kidding, Carmen H! :-)

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Re: tts after fracture...new here

Melanie E on 10/29/02 at 22:27 (098633)

Elliot what is RSD and CRPS? I had an xray a MRI which showed the fracture of the talor dome and spontaneous neucrosis of the bone. 3 months later I was sent to a neurologist and had a nerve conduction test which arrived at the diagnosis of the tarsal tunnel. I have another MRI Friday to find out the latest on this adventure.

Re: tts after fracture...new here

Kari B on 10/29/02 at 22:33 (098634)

Elliot,
LOL!! I tried a ton of things before I found this and I absolutely love it!! Some of the others I tried massaged so hard that I was in terrible pain... next day, I boxed em back up and took them back to the store and just kept trying. So, yes, it works for me... but as you know, not everything works for everyone... just keep your reciept and the box for a couple of weeks and see how it goes. I'm actually thinking of buying the full body chair that Wal-mart has by Homemedic now too LOL... it has a foot massager on it too, and it looks so comfy! I sure hope it helps you when you travel... that is the one thing that I couldnt do for a very long time and with living in California with 3 kids... I've missed out on alot of Disneyland and Six Flags trips... but after my foot gets straightened out, I don't plan to miss out on that stuff anymore! Good luck!
Kari

Re: tts after fracture...new here

Melanie E on 10/29/02 at 22:40 (098635)

Kari, I celebrated my 50th on crutches and went all out by decorating my boot cast with flowers that I painted on.My next painting will be across the back and will say Hawaii or bust..so much for Hawaii. I thought age was perhaps an issue but apparently not. I thought maybe my bones were bad becasue a few years ago I was hit by another car and broke my big toe on the other foot. Months later I had to have surgery because the bone broke off in the joint and tore up the inside of the toe requiring reconstruction. HOwever, I had a full body scan and I have good bones so I dont think the TTS is the result of that either. From the info I have read, it can just be the result of the fracture. I am hung up on using the crutches. Has anyone out there avoided surgery to begin with and have found they did or didnt get better?

Re: tts after fracture...new here

wendyn on 10/30/02 at 07:57 (098653)

Melanie - I meant to ask you about RSD as well, but I never got around to it.

I think Elliott has picked up on the fact that you mention having a cold foot.

Is your foot still cold? Is it still extremely painful to touch?

Re: tts after fracture...new here

Melanie E on 10/30/02 at 16:05 (098691)

Wendy, my leg and foot get very cold and the foot is very tender. I do have Reynauds Syndrome but it is usually in my hands. This seems different. The longer I am standing, the worse it gets. People at work were saying today the ankle was swelling again. By tonight I will be very uncomfortable and in the morning I won't feel so bad

Re: RSD (CRPS)?

Ellen F. on 10/30/02 at 19:40 (098714)

hi elliott, was wondering about the CRPS also, i am clear on what RSD, not sure of the CRPS. Saw Dr. Sammarco in Cinn. today, he left no stone unturned, very thorough exam. will be having nerve conduction studies redone, he wants done further up the leg, and also MRI of legs. He mentioned several things that could be a possible reason. I was very pleased with the visit all in all, but still having symptoms of course. My feet are also very cold all the time, is that a sign of the RSD?(Just found out that 2 of my uncles have neuropathy and one uncles started around age 50, both are elderly now and have been told the nerves are 'worn out'.)

Re: RSD (CRPS)?

elliott on 10/31/02 at 08:19 (098783)

Melanie and Ellen: RSD/CRPS is more of a systemic disorder (as opposed to a specific entrapment or even neuropathy) where the nerves sort of go haywire. One of the possible symptoms is alternating hot/cold. Several people on this board have RSD, so they could tell you more. Research is ongoing. Here's some reading to get you started.

Ellen, glad you were satisfied with Dr. Sam; he's supposed to be one of the best. Please keep us informed.

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Re: oops; here's the RSD links

elliott on 10/31/02 at 08:22 (098784)

http://www.rsds.org/about_rsd.htm

http://www.rsdinfo.com/AboutRSD.htm

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Re: RSD (CRPS)?

Melanie E on 11/03/02 at 19:26 (099210)

Elliot, thanks for the info on the RSD. I do have the alternating cold and hot. I will have the MRI results on Tuesday. I do have Atypical Connective Tissue Disease and Reynauds Syndrome due to longterm chemical exposure, but this is different. I am not too bad in the morning but as the day progresses, it hurts to even touch the ankle. It pops alot and that actually frees up some movement. Oh so gross though. Do you know how long the actual incision usually is? thanks Melanie

Re: RSD (CRPS)?

elliott on 11/05/02 at 14:56 (099450)

Melanie, suggest you ask your doc about RSD to make sure you don't have it.

Re: RSD (CRPS)?

MelanieE on 11/06/02 at 23:04 (099543)

Elliot, you may be on to something here regarding RSD. I obtained a copy of my nerve conduction test tdaoy. It has alot of numbers that I dont understand but it says the left tibial and right latencies are borderline (these nerves are normal otherwise) while the Right tibial latency is clearly prolonged. This is compatible to right TTS. patient reports symptoms which suggest RSD-could this be a factor? How nice the neurologist puts that in his notes that he faxed to my surgeon and nothing was said to me Melanie

Re: RSD (CRPS)?

elliott on 11/07/02 at 14:13 (099581)

Melanie, your doc should be on top of this to rule it RSD. If he sounds unfamilar with RSD, seek out someone who is.

On your copy of the nerve test, do you see latency numbers? (They are distance/velocity.) For the various nerves, they might range upwards from about 2.0. Do you see any that are around 7.0 or higher? Those would be the troublesome ones.

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Re: RSD (CRPS)?

MelanieE on 11/07/02 at 23:51 (099620)

Elliot, it says right tibial a 7.9 b. 16.0 d. 37.4 g 46
left tibial a 6.6 b 14.4 d 38.7 g 50
the r pevonial a 5.5 b 11.6 d. 29.8 g 49
the l peronial a 4.7 b 10.7 d. 31.0 g 52 he said the right tibial latency is clearly prolonged and compatible with right TTS. the l tibial and r pevonial latencies are borderline(these nerves are normal otherwise) He said my systems describe RSD RLE and I have Raynauds. Does this all make sense to you? Today it is raining for the first time. I would have expected to be in agony. However, today was the first day since August that I wasnt consumed with pain. Go figure? Melanie

Re: RSD (CRPS)?

elliott on 11/08/02 at 07:03 (099623)

Not sure if he's using the standard system most use, but 7.9 would be huge. OTOH, all your first numbers are somewhat higher than typical, so I'm not sure. I think you mean 'peroneal'. I don't see separate readings for both medial and lateral plantar nerves, and these again separate for both sensory and motor.

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Re: RSD (CRPS)?

MelanieE on 11/09/02 at 11:07 (099666)

Thanks Elliot I can't figure out what it all means. However, I did go back to the MRI technician and ask why wasn't the TTS addressed in the doctor's report? He said it was an error and the doctor would review the MRI and send an additional report to my surgeon. That ought to be interesting since my surgeon said they can't tell about TTS from MRI's. I will just get a copy of the report and take it to the other doctor I am seeing at the end of the month.

Re: RSD (CRPS)?

Ellen F. on 11/09/02 at 11:21 (099668)

hi melanie, i go next wed. to have the dr. tell me what he saw on recent MRI and also nerve studies, it will be interesting to see if the TTS is picked up or not on the MRI. are you seeing ortho. dr. or podiatrist at the end of the month? seems like you got some conflicting info. should be interesting to find out wht the other dr. has to say about it all. i will say that the bi-lateral MRI that i had lasted 3hrs. and i have probably 20 or more sheets of photos for the dr.(lucky him), and being curious(some may say 'nosey')like i am i took out the sheet that had my right foot and ankle and then the left one that was the same views and the right looked very different from the left, there were some black spots near the inner part of the heel and bottom of heel near ankle on the right and not on the left. i am not a dr. and don't really know what i'm looking at but i believe there was a difference, whether that was any indication of the TTS, don't know, but will find out soon i guess.

Re: RSD (CRPS)?

MelanieE on 11/09/02 at 11:33 (099670)

Hi Ellen, there should be a report with the MRI of what it all means. I asked for a copy of it so I could look up the diagnosis on the web and take it to the sports podiatrist at the end of the month. By then, not only will I have the additional report from the MRI but I will know if this pain-free few days is just a temporary reprieve. By the way, the doctors sometimes do act like we are being nosey but hey it is our bodies When I had pneumonia, my doctor told me to bring the xrays back to her so she could also look at them. The imaging office refused stating that their radiologist had already looked at them. I told them to call their malpractice insurance carrier and ask them if there was a good reason why they should object to a second opinion. Needless to say, I walked out with xrays in hand. I really don't like being jerked around and am kind of feeling like I am by my orthopedic surgeon. That is why I am anxious to get my reports and a second opinion. If he had his way, I would have already been on the operating table two weeks ago. Melanie

Re: RSD (CRPS)?

elliott on 11/09/02 at 18:52 (099684)

Melanie, it is true that it is very rare to detect the actual TTS from an MRI. At the same time, an MRI is very valuable for TTS. Something caused your TTS. That something might show up on the MRI and so it may be a decisive factor as to whether surgery is advised, as well as indicating what else might have to be repaired in order to fix your problem.

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Re: tts after fracture...new here

elliott on 10/28/02 at 18:20 (098512)

Hi, Kari! Sorry for your troubles. Sounds like you're contemplating a TTS release (I had it done in both feet.) The surgery releases the nerve by cutting away a band of tissue to give it more room to move. In your case, it might also entail scraping away bone or some such (did your surgeon discuss that with you? I presume you had an xray). It is my understanding that when TTS results from something like a fracture, it is less likely to go away by itself since something has moved out of place to interfere with the nerve, so a decision as to surgery may be easier. The consensus is that if an MRI shows something that is likely to be causing your problems and that will be addressed at surgery, your chances are better. Of course, success rates for TTS surgery are a bit lower than for most; results are sometimes unpredictable. In the case of fracture, there is always the possibility that permanent damage has been done to the nerve. But the wife of a podiatrist I used who got TTS from a fractured ankle had the TTS release and recovered 100%. Good luck.

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Re: tts after fracture...new here

Kari B on 10/29/02 at 01:07 (098524)

Elliot,
Thank you for those encouraging words... I think that is what I was looking for to feel better after reading about all the failed tts releases. My Dr has explained that there could be more in there than what we have seen on the MRI... he also did bone scans, a gallium scan, etc. I'm glad he didn't just dive headfirst into the idea of surgery and has done everything that I have been reading about before contemplating this idea. It does make me feel safer knowing that he obviously is aware of the treatments and alternatives BEFORE surgery as I had a neurosurgeon a few years back remove 90% of my L4-L5 disc that was sitting on the S1 nerve but never told me there were options... go figure... he told me about the steroid shots and epidurals AFTER he did all the cutting and it didn't get rid of all my back pain. Luckily after several years of PT and watching what and how I do things I have finally reached about 95% relief from pain. LOL... and now this! Well, I'm hoping that the surgery will relieve the pain but I am not expecting immediate relief. Doc has stated that it could take anywhere from immediately to a year (depending on how my body heals, and especially being a nerve) for me to see complete relief. He has also made me aware that the possibility for permanent damage from the bone fracture is something I could be facing as well. I feel comfortable that he has been keeping me informed as to all options, risks, and possibles that can happen. Anyway, I want to thank you for responding, I have gained quite a bit of information from posts on this board, it's been a life saver!
Kari

Re: tts after fracture...new here

elliott on 10/29/02 at 08:09 (098534)

I also have the L4-L5 thing, lower back/butt/hamstring irritation on right side, now over 3 1/2 years, starting around the time of my first TTS surgery. The back was so bad back then that I was close to surgery despite my reservations and fears but got lucky finding out about epidurals, etc. Got an epiduroscopy (scope-guided epidural) this past March I think it was, and that brought the pain level permenently down a chunk, as has yoga, other exercise, hanging on an inversion sling, occasional Aleve (Celebrex and Vioxx did nothing) and the passage of time. I'm past the stage of risking the full disc surgery, but after travelling to N.J. last week, 3 hours each way all in one day (youch!), I realize I still have quite a ways to go. It's been a long time and I'm weary. Do you have anything to add by way of advice? Thanks!

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Re: tts after fracture...new here

Kari B on 10/29/02 at 11:13 (098551)

Hi Elliot,
Sounds like you've got things well under control, although, when you travel you need to remember to stop at least once an hour for 30 minutes and do some of you stretching exercises if its possible. Also, something my husband got me was a chair pad which plugs into the cigarette lighter in my truck and it has vibration (light, medium, or high) and you can also have heat with it too. When I'm traveling anywhere, that is a God send!!! That way I'm still recieving the input from the vibrations and I go back and forth with the heat, say... 10 minutes with heat on, 30 minutes with heat off.../ whatever feels the most comfortable. You can find these at any drugstore/medical supply store... even Wal-mart carries them if you can find them quickly. And, they are NOT expensive!!
I was given sets of stretching exercises to do by my PT before I even get out of bed and I do them every morning... it really does start my day off right. Although with doing the yoga and all, it definitely sounds like you are on the right track, just dont overdo it!! I know this probably sounds stupid too, but I very rarely lift anything over 15 lbs, I try to stay away from any activity that requires me to bend repetively. When I do bend to pick up something, I rely more on my legs than my back and that was sooooooooooo hard for me to learn how to do. If you have any other questions or suggestions for me, I'm here!! Good luck to you... I feel you are a very strong person having been able to make it through all this with your back without falling into surgery... I just wanted them to cut my leg off and get it overwith LOL! Hugs to ya,
Kari

Re: tts after fracture...new here

elliott on 10/29/02 at 13:24 (098567)

Kari:

I think the reason I held out at that time getting my back operated on was that my feet were having post-surgical trouble!

There's no way I can spend half my travel time at rest stops doing stretching; popping an Aleve on those occasions helps, as long as my stomach can deal with the explosives.

Thanks for the tip on the seat. In case I have trouble locating it, do you have a brand name or something to go on? Thanks.

[]

Re: tts after fracture...new here

Kari B on 10/29/02 at 17:23 (098600)

Yes, its by the brand name of Homemedics.... they also make other types of back supports, shower stall handles, knee braces, just about anything someone could need for health. I'm not sure, but they may have a website, I have never thought to check. Good luck (I like Aleve as well when I cant take anything stronger)

Re: tts after fracture...new here

Melanie E on 10/29/02 at 19:57 (098609)

I am glad to have found this site and to read these messages. I broke the talor dome bone in the ankle and had spontaneous neucrosis. I was on crutches for 2 months. Now I have tarsal tunnel syndrome and was told my choices are to live with it or have surgery. I am having another MRI this week to see if the bone that died is growing back. If it hasn't then surgery will be needed anyway to drill holes in the bone to stimulate growth so I would then have the nerve released at the same time. I still limp and the pain is very constant. I haven't missed a day of work but as my tolerance goes down from the pain I am considering sriously having the surgery. How long after surgery were you on crutches? Did they cut the nerve or just clean out scar tissue? thanks

Re: tts after fracture...new here

elliott on 10/29/02 at 21:17 (098619)

Kari, I'll check it out. Thanks!

Re: tts after fracture...new here

Kari B on 10/29/02 at 21:17 (098620)

Melanie,
I haven't had the surgery yet. We are waiting for the authorization from insurance and then the dr will give me a call to let me know when its scheduled for. Most likely I will be having it done next week, so I will post updates here as much as possible afterwards. I'm sorry to hear you've been in so much pain... I like you have not had any relief in pain since I fractured my foot. According to my Dr, he plans to go in and clean out the scar tissue that has built up from the fracture and put some kind of medication into the nerve to keep it from getting infected or any more inflamed. He will check to make sure there is nothing else going on that hasnt shown up on all of the tests he's done and then close it up. He told me that when I wake up, I will have a fairly large soft cloth type of cast on it for the 1st week and then I will be going back into my boot for awhile... at the minimum of 3 weeks. He's said that it takes quite a bit of time to heal from this type of surgery and to just plan to take my time and only do what feels comfortable to me. I will also be back on non-weight bearing restriction and crutches for at least the first 4 weeks. This all I basically know right now, but if I have my surgery before you, I will definitely report here what/how things go. Good luck to you and keep me updated on yourself as well! Take care!
Kari

Re: tts after fracture...new here

Kari B on 10/29/02 at 21:30 (098622)

Elliot,
I found one online at walmart.com if you want to check it out... the one I have has the AC and 12 volt adapters for home or vehicle use. I'm not sure if posting links here works or not, but here goes

http://www.walmart.com/catalog/product.gsp?cat=36290&dept=4044&product_id=1926340&path=0%3A4044%3A36290%3A77957%3A4571

I hope it works for you!
Kari

Re: tts after fracture...new here

Melanie E on 10/29/02 at 21:48 (098625)

Kari, thanks for your response. Egad, next week huh? You definitely will be ahead of me as I won't have the surgery until December. In the meantime I will grit my teeth and limp. If the bone (talor dome in the heel) is growing back, then I am crossing my fingers unrealistically that the pain will go away and I wont need surgery. If the bone isn't growing back, then holes would have to be drilled in the heel and I would have the tarsal tunnel dealt with at the same time. I just put those dang crutches away and am not ready to submit to being on non-weight bearing again. It was very difficult carrying anything and I had to use a packback. I am coming to the brillant conclusion that this is a long haul to recovery. I am relieved to find out what it is though. I was getting very nervous about the leg getting so cold, the shooting pain in the heel and up the leg and the numbness. thanks again, Melanie

Re: tts after fracture...new here

elliott on 10/29/02 at 22:17 (098630)

Melanie, did you get checked for RSD (CRPS)?

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Re: tts after fracture...new here

Kari B on 10/29/02 at 22:19 (098631)

Melanie,
Do you mind me asking how old you are? I kept thinking that my foot wasnt healing right or something because of my age lol... I'm 31 (but with 3 kids!) When I mentioned that to my orthoped, he laughed so hard, luckily he has a good humor. Anyway, the avascular necrosis is something he thought might be going on, but the gallium scan didn't show any cold spots and it hasnt been detected on MRI or x-ray... so I'm praying thats not whats going on with it too. I agree Totally with you about the crutches, I couldn't wait to toss those things and now I have to use them again and I think I'm actually dreading that more than the surgery itself!
Kari

Re: tts after fracture...new here

elliott on 10/29/02 at 22:22 (098632)

Thanks!! I might just buy it! But you sure this thing works? I'm starting to feel like I'm Carmen H; she tries everything. :-) Just kidding, Carmen H! :-)

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Re: tts after fracture...new here

Melanie E on 10/29/02 at 22:27 (098633)

Elliot what is RSD and CRPS? I had an xray a MRI which showed the fracture of the talor dome and spontaneous neucrosis of the bone. 3 months later I was sent to a neurologist and had a nerve conduction test which arrived at the diagnosis of the tarsal tunnel. I have another MRI Friday to find out the latest on this adventure.

Re: tts after fracture...new here

Kari B on 10/29/02 at 22:33 (098634)

Elliot,
LOL!! I tried a ton of things before I found this and I absolutely love it!! Some of the others I tried massaged so hard that I was in terrible pain... next day, I boxed em back up and took them back to the store and just kept trying. So, yes, it works for me... but as you know, not everything works for everyone... just keep your reciept and the box for a couple of weeks and see how it goes. I'm actually thinking of buying the full body chair that Wal-mart has by Homemedic now too LOL... it has a foot massager on it too, and it looks so comfy! I sure hope it helps you when you travel... that is the one thing that I couldnt do for a very long time and with living in California with 3 kids... I've missed out on alot of Disneyland and Six Flags trips... but after my foot gets straightened out, I don't plan to miss out on that stuff anymore! Good luck!
Kari

Re: tts after fracture...new here

Melanie E on 10/29/02 at 22:40 (098635)

Kari, I celebrated my 50th on crutches and went all out by decorating my boot cast with flowers that I painted on.My next painting will be across the back and will say Hawaii or bust..so much for Hawaii. I thought age was perhaps an issue but apparently not. I thought maybe my bones were bad becasue a few years ago I was hit by another car and broke my big toe on the other foot. Months later I had to have surgery because the bone broke off in the joint and tore up the inside of the toe requiring reconstruction. HOwever, I had a full body scan and I have good bones so I dont think the TTS is the result of that either. From the info I have read, it can just be the result of the fracture. I am hung up on using the crutches. Has anyone out there avoided surgery to begin with and have found they did or didnt get better?

Re: tts after fracture...new here

wendyn on 10/30/02 at 07:57 (098653)

Melanie - I meant to ask you about RSD as well, but I never got around to it.

I think Elliott has picked up on the fact that you mention having a cold foot.

Is your foot still cold? Is it still extremely painful to touch?

Re: tts after fracture...new here

Melanie E on 10/30/02 at 16:05 (098691)

Wendy, my leg and foot get very cold and the foot is very tender. I do have Reynauds Syndrome but it is usually in my hands. This seems different. The longer I am standing, the worse it gets. People at work were saying today the ankle was swelling again. By tonight I will be very uncomfortable and in the morning I won't feel so bad

Re: RSD (CRPS)?

Ellen F. on 10/30/02 at 19:40 (098714)

hi elliott, was wondering about the CRPS also, i am clear on what RSD, not sure of the CRPS. Saw Dr. Sammarco in Cinn. today, he left no stone unturned, very thorough exam. will be having nerve conduction studies redone, he wants done further up the leg, and also MRI of legs. He mentioned several things that could be a possible reason. I was very pleased with the visit all in all, but still having symptoms of course. My feet are also very cold all the time, is that a sign of the RSD?(Just found out that 2 of my uncles have neuropathy and one uncles started around age 50, both are elderly now and have been told the nerves are 'worn out'.)

Re: RSD (CRPS)?

elliott on 10/31/02 at 08:19 (098783)

Melanie and Ellen: RSD/CRPS is more of a systemic disorder (as opposed to a specific entrapment or even neuropathy) where the nerves sort of go haywire. One of the possible symptoms is alternating hot/cold. Several people on this board have RSD, so they could tell you more. Research is ongoing. Here's some reading to get you started.

Ellen, glad you were satisfied with Dr. Sam; he's supposed to be one of the best. Please keep us informed.

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Re: oops; here's the RSD links

elliott on 10/31/02 at 08:22 (098784)

http://www.rsds.org/about_rsd.htm

http://www.rsdinfo.com/AboutRSD.htm

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Re: RSD (CRPS)?

Melanie E on 11/03/02 at 19:26 (099210)

Elliot, thanks for the info on the RSD. I do have the alternating cold and hot. I will have the MRI results on Tuesday. I do have Atypical Connective Tissue Disease and Reynauds Syndrome due to longterm chemical exposure, but this is different. I am not too bad in the morning but as the day progresses, it hurts to even touch the ankle. It pops alot and that actually frees up some movement. Oh so gross though. Do you know how long the actual incision usually is? thanks Melanie

Re: RSD (CRPS)?

elliott on 11/05/02 at 14:56 (099450)

Melanie, suggest you ask your doc about RSD to make sure you don't have it.

Re: RSD (CRPS)?

MelanieE on 11/06/02 at 23:04 (099543)

Elliot, you may be on to something here regarding RSD. I obtained a copy of my nerve conduction test tdaoy. It has alot of numbers that I dont understand but it says the left tibial and right latencies are borderline (these nerves are normal otherwise) while the Right tibial latency is clearly prolonged. This is compatible to right TTS. patient reports symptoms which suggest RSD-could this be a factor? How nice the neurologist puts that in his notes that he faxed to my surgeon and nothing was said to me Melanie

Re: RSD (CRPS)?

elliott on 11/07/02 at 14:13 (099581)

Melanie, your doc should be on top of this to rule it RSD. If he sounds unfamilar with RSD, seek out someone who is.

On your copy of the nerve test, do you see latency numbers? (They are distance/velocity.) For the various nerves, they might range upwards from about 2.0. Do you see any that are around 7.0 or higher? Those would be the troublesome ones.

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Re: RSD (CRPS)?

MelanieE on 11/07/02 at 23:51 (099620)

Elliot, it says right tibial a 7.9 b. 16.0 d. 37.4 g 46
left tibial a 6.6 b 14.4 d 38.7 g 50
the r pevonial a 5.5 b 11.6 d. 29.8 g 49
the l peronial a 4.7 b 10.7 d. 31.0 g 52 he said the right tibial latency is clearly prolonged and compatible with right TTS. the l tibial and r pevonial latencies are borderline(these nerves are normal otherwise) He said my systems describe RSD RLE and I have Raynauds. Does this all make sense to you? Today it is raining for the first time. I would have expected to be in agony. However, today was the first day since August that I wasnt consumed with pain. Go figure? Melanie

Re: RSD (CRPS)?

elliott on 11/08/02 at 07:03 (099623)

Not sure if he's using the standard system most use, but 7.9 would be huge. OTOH, all your first numbers are somewhat higher than typical, so I'm not sure. I think you mean 'peroneal'. I don't see separate readings for both medial and lateral plantar nerves, and these again separate for both sensory and motor.

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Re: RSD (CRPS)?

MelanieE on 11/09/02 at 11:07 (099666)

Thanks Elliot I can't figure out what it all means. However, I did go back to the MRI technician and ask why wasn't the TTS addressed in the doctor's report? He said it was an error and the doctor would review the MRI and send an additional report to my surgeon. That ought to be interesting since my surgeon said they can't tell about TTS from MRI's. I will just get a copy of the report and take it to the other doctor I am seeing at the end of the month.

Re: RSD (CRPS)?

Ellen F. on 11/09/02 at 11:21 (099668)

hi melanie, i go next wed. to have the dr. tell me what he saw on recent MRI and also nerve studies, it will be interesting to see if the TTS is picked up or not on the MRI. are you seeing ortho. dr. or podiatrist at the end of the month? seems like you got some conflicting info. should be interesting to find out wht the other dr. has to say about it all. i will say that the bi-lateral MRI that i had lasted 3hrs. and i have probably 20 or more sheets of photos for the dr.(lucky him), and being curious(some may say 'nosey')like i am i took out the sheet that had my right foot and ankle and then the left one that was the same views and the right looked very different from the left, there were some black spots near the inner part of the heel and bottom of heel near ankle on the right and not on the left. i am not a dr. and don't really know what i'm looking at but i believe there was a difference, whether that was any indication of the TTS, don't know, but will find out soon i guess.

Re: RSD (CRPS)?

MelanieE on 11/09/02 at 11:33 (099670)

Hi Ellen, there should be a report with the MRI of what it all means. I asked for a copy of it so I could look up the diagnosis on the web and take it to the sports podiatrist at the end of the month. By then, not only will I have the additional report from the MRI but I will know if this pain-free few days is just a temporary reprieve. By the way, the doctors sometimes do act like we are being nosey but hey it is our bodies When I had pneumonia, my doctor told me to bring the xrays back to her so she could also look at them. The imaging office refused stating that their radiologist had already looked at them. I told them to call their malpractice insurance carrier and ask them if there was a good reason why they should object to a second opinion. Needless to say, I walked out with xrays in hand. I really don't like being jerked around and am kind of feeling like I am by my orthopedic surgeon. That is why I am anxious to get my reports and a second opinion. If he had his way, I would have already been on the operating table two weeks ago. Melanie

Re: RSD (CRPS)?

elliott on 11/09/02 at 18:52 (099684)

Melanie, it is true that it is very rare to detect the actual TTS from an MRI. At the same time, an MRI is very valuable for TTS. Something caused your TTS. That something might show up on the MRI and so it may be a decisive factor as to whether surgery is advised, as well as indicating what else might have to be repaired in order to fix your problem.

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