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question-surgery schedule for next week

Posted by Reb on 12/15/02 at 02:22 (103166)

I also posted this on the Ask the Doctor board:

I had an open PF surgery (2/3 release) last year, went through the recovery period, slowly resumed activity and was joyfully pain free for about two months. Although the pf pain was gone the lateral bottom of my foot started really hurting. Actually it's far far worse than my original pf pain, really debilitating. I had my orthotics modified, reduced my activity, had an injection in the calcaneocubiod joint, went to PT for cuboid manipulations and ultrasound but the pain got steadily worse until I was put in a cast for 6 weeks (which, if anything, made it worse). A bone scan didn't show any problems with the calcaneocubiod joint but with the remaining lateral band of the pf. There is also tenderness going up the side of my foot from the fifth metatarsal toward the lateral malleolus. My pod thought that there might be something also going on with the peroneal tendons, so I had an MRI. It showed a really huge area of fluid in the lateral pf but only slight thickening of the tendon.

Surgery is scheduled for next Tuesday to release the remaining lateral band of the pf. My pod tossed around the idea of exploring the peroneal tendons at the same time but has decided that there would be more risk than benefit to do that. He also thought the pain might be from guarding. I did research on the internet about peroneal tendon tears and found an article of case studies which seemed to really fit me: middle age runners often with high arched feet and history of ankle sprains from trail running. The main thing that I really latched on to was that all of these people had exploratory surgery and then tendons were repaired and a few months later they were all running again. Sigh, I want THAT!

If you've managed to get this far, what I'd like to know is if you think it would be worthwhile for me to press him to check it out. I know that it's a much bigger deal surgically to do that and not without risk, but if there is something going on, I'd so much rather deal with it now than possibly have to go through another surgery down the line.

Re: question-surgery schedule for next week

Dr. Z on 12/15/02 at 08:55 (103176)

The problem that you are having is from the 2/3 pf release. The entire plantar fascia is the main supportive structure of your foot. When cutting the fascia it can heal weak and thus your entire weight is shifted to the lateral side of your foot. this is a very hard problem to resolve> An mri would show you any tear in the peroneal tendons>

Re: question-surgery schedule for next week

Pauline on 12/15/02 at 14:48 (103213)

In my opinion you should save yourself the possibility of more pain from additional surgery until you do more homework and get all your questions answered. Put your surgery on hold. There is no guarantee rushing into this next one will provide you with any more relief than you got from the first. You started your research, now finish it before you have more surgery.

If you read the surgical postings on this site you'll find many people who rushed into what I call 'Snowballing Surgeries' and now live to regret their decisions.

Did you ever think of getting a second opinion before having more surgery by the same doctor? It won't ruin your chances for having another surgery, but it might just provide you with a more successful one. There are many doctors out there willing to cut your feet, but the trick is finding out before hand if it will really improve your current condition on only add to it.

The foot is more complicated than most people realize. Surgery in one part always seem to have an affect on another. If I were you I'd cancel this surgery until you get a few more opinions and do some more of that research you started. Don't forget to bring those studies along the next time you visit a doctor.

Re: question-surgery schedule for next week

Sharon W on 12/15/02 at 14:56 (103217)

I agree. Since your results were not good the FIRST time around with this surgeon, it would make sense to at least see someone else and get another opinion (perhaps even another OPTION!) before going ahead and having him operate again.

Sharon

Re: question-surgery schedule for next week

Reb on 12/15/02 at 19:44 (103236)

I've had a second and third opinion. The first one had a pretty complicated theory (Baxter Nerve entrapment increasing peroneal activity causing the calcaneocuboid joint to sublux) which didn't really fit. The third guy agreed that the lateral band of the fascia was over burdened as a result of the pf surgery.

Re: question-surgery schedule for next week

Reb on 12/15/02 at 19:52 (103238)

I guess I didn't provide all the details but truly I am not going into this surgery half baked. I have done a ton of research, it's been my obsession for over a year. The whole tendon thing was my idea based on things I've read and my doctor went along with it far enough to order a MRI and go over the films with me carefully. He even called in another doctor to look at them and give his opinion. He agreed that there might be a slim possibility that something could be going on with the tendon but he doubts it based on the MRI.

Re: question-surgery schedule for next week

Dr. Z on 12/15/02 at 20:00 (103239)

It is the calcanel cuboid joint that is usually what is causing your problem. I will refer to an article I believe is on this web site by Dr. Downey. He talks about a fusion of this joint to stop the pain.
I would try to look for it

Re: Here is the article. came from this site

Dr. Z on 12/15/02 at 20:03 (103240)

Complications and treatment
Lateral destabilization problems, including calcaneocuboid syndrome, are perhaps the most common complications associated with the EPF procedure. As mentioned, avoiding or diminishing the risk of these complications by releasing less of the fascia would seem to be advisable. Further, a more restrictive postoperative course, including several weeks of limited or partial weight-bearing, a short leg walking cast, and/or night rest splints might diminish the frequency of these lateral column problems.
When the problem of calcaneocuboid syndrome does occur, it should be managed in an aggressive but conservative fashion. Barrett et al7 recommended that initial treatment consist of decreased ambulation and standing, stretching exercises, NSAIDs, orthoses, and physical therapy. If this regimen fails to alleviate the problem, they recommend a removable cast boot or referral to another surgeon experienced in the EPF technique, a pain management specialist, or a neurologist. In certain cases, where nerve entrapment or a potential chronic pain problem are possibilities, referral might be considered. However, in most cases, diligent continuation of conservative measures oriented towards the amelioration of inflammation and mechanical control of the calcaneocuboid joint will lessen or resolve the patient's symptomatology. I recommend orthotic management with a cuboid pad to help lock the calcaneocuboid joint, or a course of nonweight-bearing in a short leg cast for four to six weeks. Corticosteroid injections, NSAIDs, and physical therapy are used as adjunctive measures. As a last resort, in cases unresponsive to conservative treatment, calcaneocuboid joint arthrodesis or midtarsal joint arthrodesis may be necessary.25

Michael S. Downey, DPM, is professor and chairman of surgery at Temple University School of Podiatric Medicine in

Re: Here is the article. came from this site

Reb on 12/15/02 at 20:17 (103242)

Thanks, Dr. Z. I've read this also and showed it my doctor. I've gone through all the above conservative care: NSAIDS, physical therapy, stetching, cuboid manipulation, injections, rest, othodic adjustment, boot cast, then non-weight bearing hard cast for six weeks. The thing is that both the MRI and bone scan do not indicate a problem with the calcaneocuboid joint. It's all in the lateral band of the fascia. My doctor doesn't see that a joint fusion is going to help. I found something that you wrote while a doing a search on this site about going back in to release the lateral band after partial releases to treat lateral column pain?

Re: Here is the article. came from this site

Dr. Z on 12/15/02 at 21:00 (103245)

You can always go to the joint fusion if the lateral band release doesn't give you the LONG term relief you are seeking. Good Luck and keeps us informed.

Re: Well wishes

Sharon W on 12/15/02 at 23:08 (103253)

Reb,

It sounds like you have researched extensively, have gotten other opinions, have established trust in your surgeon, and have made up your mind! So, I wish you the best of success with your surgery and hope it will be accomplished with a minimum of discomfort.

And please do post to this board again afterward, to let us know how you're feeling. I think I got the wrong impression about where you were with respect to your treatment, etc. -- people sometimes do rush forward into surgery (where angels fear to tread).

Sharon

Re: question-surgery schedule for next week

t eiford on 12/16/02 at 09:58 (103280)

hi it sounds you are in the same boat as me,i went back to the dr this morning, he said my mri showed a lot of fluid and scar tissue and that he could not asure that he could fix the problem. do i do the 2rd surgery or remain in severe pain ?

Re: question-surgery schedule for next week

Pauline on 12/16/02 at 11:45 (103294)

You put your surgery on hold, gather all your medical records, including x-rays, MRI's and other tests, your first surgical report and seek a second opinion or opinions from other Pods and Orthopedic Surgeons who specialize in foot and ankle surgery. If you tried a Pod see what the Ortho says.

You also finish the homework you started by looking for more studies or abstracts that may help you define your condition. When you go for your next opinion or opinions go armed with all this material and your records.

What you don't want to do is rush into another surgery thinking this one is your sure cure. I have yet to see 'snowballing surgeries' help anyone. Just look at the surgical postings for proof.

You could almost say some foot surgeries are bibical because one usually begets another and that one begets the next until finally down the road the doctor tells you to seek your pain relief from a Pain Clinic.

Some people are afraid to cancel a surgery because they fear what the doctor will think of them or that he will get mad because they want another opinion.

Most doctors don't fear you getting several opinions and if they do then you really need a new one. Remember your in charge of your body do all your measuring (homework) before you let someone cut into it.

People in pain sometimes make poor decisions because they are in a hurry for relief. Remember there is no guarantee any surgery will make you pain free.

Re: question-surgery schedule for next week

Reb on 12/16/02 at 12:56 (103299)

Hi t eiford, What surgery did you have and where does it hurt? I know how hard it is to decide what to do when you're in pain.

Re: Well wishes

Reb on 12/16/02 at 13:44 (103304)

Thanks, Sharon. You weren't the only one to get the wrong impression which can only mean that I wasn't clear when I posted originally. It was late at night after a long day preparing and hosting a birthday party for my nine year old son while nearly incapacitated with foot pain... I've read many of your posts and recall people trying to talk you out of your recent surgery. Do you still feel that you did the right thing? I remember that you really trust your doctor. I feel the same way. He tried getting approval to go out of Kaiser for ESWT. I did years of conservative treatment before he even considered surgery. Truly this isn't as hasty or ill informed as it must have appeared to you. I will let you know how it goes. Thanks.

Re: question-surgery schedule for next week

wendyn on 12/16/02 at 14:18 (103306)

Tammie - do you have any comments on this thread?

Re: question-surgery schedule for next week

Ed Davis, DPM on 12/16/02 at 16:55 (103315)

Please see my post on the doctors board. Your problem should be handled conservatively.
Ed

Re: question-surgery schedule for next week

t eiford on 12/16/02 at 17:25 (103322)

Hi,i had tts/open fashia surgery in febuary of this year and all my pain is heal ,arch, shooting pain going up leg when walking,the doctor said the mri showed a lot of fluid and scar tissue, he said that some folks get 100 % inprovment and some get none ! he could not guarantee he out come but it was totaly my discion. so do i live with this pain or go for the gusto ineed to get my feet back somehow. i have lost my job over this had to take hushand off insurance. well thats enought chating if i have the surgery it will be on the 31 of this month.
trish

Re: Well wishes

Sharon W on 12/16/02 at 18:02 (103333)

Reb,

You do have a good memory! That was 5 months ago. But of course, my surgery was for TTS -- a different situation from yours.

Yes, I still feel that I did the right thing, having the surgery. I feel about 80% better than I did before the surgery, which I consider to be a good ('successful') result. (I was even able to make Christmas cookies this year!)

Surgery sometimes gets a bad rap on these boards, I think, because there are so many people posting here who did NOT have favorable results for their procedures. NOT that I think surgery is the first or the best or the easiest answer -- it should be the LAST resort, but in some cases it is necessary.

Sharon

Re: Trust Dr. Ed.

Tammie on 12/16/02 at 22:57 (103364)

I am sorry have not seen this but yes I would like to say a few things.
1,never make a decision about surgery when you are in pain!!! Pain first of all will make you do anything at all to get rid of it, even a second or third surgery!

Take a person who can hear for you and understand what is being said! Dont trust your own ears as remember you hurt so darn bad you will hear what you want!

If you are in pain and it is unbareable, Find a DR who can treat this and give you some good sleep and allow your memory to come back. Who can make a good decision when it is weeks and weeks with pain and no good sleep?

If this is your second surgery by the second Dr. be sure of what he is doing as a second surgery could work of course , but sometimes they do not work! You may end up like me or some of us here.

I found a pain management DR. I am the person who was healthy all my life no pills not even tylonol,ever.Said I dont believe in Drugs or drug therapy,Huh what a laugh,the only thing I ask myself is WHY did I suffer so long and Why did I have not 1 but 2 surgeries?

My answers are this, Lack of sleep major lack of sleep, pain that was not in a seperate spot it seemed to me that it was getting worse than better and finally I got some help and I will say yes I take a variity of meds,I am not thrilled about it but this is what I have learned from my pain Dr.s

The most important thing is give my self permission to take medication to help me feel better. First this is say if It was my heart or cancer or such ,and I had to take medications to live,then why allow my self to suffer in pain ? Ilearned as long as you follow what your Dr, plans of care is followed! You work at getting yourself to a point that you can function at the scale. The scale is of course a ten for tops doubtful,That I will see that but our goal is to get to a 4 and consider that a major advance! I forgot to tell you I now have RSD and it has been comfirmed by so many tests and alot of things and I am not sure if it was in any conection to the 2 surgeries or not but had I been able to retrace it would have been NO to either surgery and to find a Group of Dr.s to make a care plan of ME not my foot But ME ,I needed a group to help me with all that goes with chronic pain,I cant begin to tell you how it feels to have a good nights sleep with no pain,make it 2 and you might be able to see a future ahead! Please do what is best for you and yourself.

But Please take care of all of yourself and give yourself the right to find A Dr. or DRS to help make a plan of care not just surgery and bye ,I cant do more for you! I dont mean to say all Dr.s are like this but I found That pain sure does allow you to do anything that might take it away. Please be real sure of what you do!I am the flip side of surgery ,not healed but made my life a nightmare and not a few weeks or months,it feals life forever and maybe it is but i now trust my body to tell me what I need. I hope I dont say anything to frighten you or sound like I am not encouraging you, Please take time to take good care of you, I will never ever have me back. I walk with a cane and sometimes need a wheelchair, both of which I hate with a passion, but if I wish to get around I must do what it takes. Read about me if you choose , I had quite alot to deal with and I was hysterical at times .Forgive me , as I to was in those areas of pain and and more and no rest and no answers! Take care and I hope whatever you choose you will come back and let us know how things are going and know that we will be here to support you!!!

Good luck on the search of answers for your body and yourself!

Re: Well wishes

Sharon W on 12/17/02 at 07:02 (103375)

I should add that Dr. Ed, Dr. Wander, and Dr. Z are all excellent, caring, trustworthy professionals and I would take VERY seriously any warnings and opinions from them.

Sharon

Re: Pain meds ??

BrianG on 12/17/02 at 21:00 (103439)

Hi Trish and Reb,

I'd just like a second to tell you how fortunate you are to get all this advice, BEFORE the fact. Most patients end up here after multiple surgeries, when not a lot can be done. It's unfortunate, but there are so many nerves in the foot, the slightest mistake, or bad luck, and you could end up with extreme pain for many years to come.

Have you tried a pain management doctor, or clinic, until you feel you have 100% information you need to have that surgery. A good PM doc will start you out at a very low level of narcotics. You will barely know you are on the meds. He will slowly build you up, so that you can still work, if necessary. You'll also be able to sleep at night, which will give you a clearer head to make the best decision you can make. If not, you may feel rushed, as if there is no alternative, to have surgery that could give you pain much worse than you have now. Please don't think this can only happen to other people, this board is full of people who live in agony, people who rushed into something that really had no chance of curing them. Remember, a surgeon is paid to cut, thats what he does, and thats what he will usually recommend. Just ask him if he will guarantee his work !!!!

I pray you make the right decisions
BrianG

Re: Pain meds ??

t eiford on 12/17/02 at 21:28 (103443)

Hi Brian,thanks for the advise it is very good advice,if you read back a ways i did take your advice and went to a pain managment doctor and he said I needed to go to an expert doctor so he can try to undo the damage thats been done, gave me some lididerm patches and sent me away to this new doctor who put me back in air cast for 8 weeks ordered mri and all pre and post tests done before my surgery in feb. He said the mri showed alot of fluid and scar tissue, and all that he can try and do is go in and move the nerves and the chances were 60/100 some folks feel 100% and some get worse. told me to stay on the same medication that has done nothing but fry my 50 year old memory, he said that was the only med he would recommend for the burning and tingling.I see my primary doctor in the morning and we will talk about the surgery that is already set for new years eve day.I will keep you posted.thanks for replying. trish

Re: Pain meds ??

BrianG on 12/17/02 at 21:57 (103448)

Trish,

There are good pain docs, and then there are pain docs who should not even be practicing. Yours sounds like someone in the middle. A good pain doc will work with you, weekly if necessary, to ensure your pain is slowly getting under control. I believe you are in need of a pain doc who has compassion. Take a quick look at this web site: http://www.pain.com Near the bottom of the main page, there is a link to pain clinics in each state. I wish you luck.

BrianG

Re: question-surgery schedule for next week

Dr. Z on 12/15/02 at 08:55 (103176)

The problem that you are having is from the 2/3 pf release. The entire plantar fascia is the main supportive structure of your foot. When cutting the fascia it can heal weak and thus your entire weight is shifted to the lateral side of your foot. this is a very hard problem to resolve> An mri would show you any tear in the peroneal tendons>

Re: question-surgery schedule for next week

Pauline on 12/15/02 at 14:48 (103213)

In my opinion you should save yourself the possibility of more pain from additional surgery until you do more homework and get all your questions answered. Put your surgery on hold. There is no guarantee rushing into this next one will provide you with any more relief than you got from the first. You started your research, now finish it before you have more surgery.

If you read the surgical postings on this site you'll find many people who rushed into what I call 'Snowballing Surgeries' and now live to regret their decisions.

Did you ever think of getting a second opinion before having more surgery by the same doctor? It won't ruin your chances for having another surgery, but it might just provide you with a more successful one. There are many doctors out there willing to cut your feet, but the trick is finding out before hand if it will really improve your current condition on only add to it.

The foot is more complicated than most people realize. Surgery in one part always seem to have an affect on another. If I were you I'd cancel this surgery until you get a few more opinions and do some more of that research you started. Don't forget to bring those studies along the next time you visit a doctor.

Re: question-surgery schedule for next week

Sharon W on 12/15/02 at 14:56 (103217)

I agree. Since your results were not good the FIRST time around with this surgeon, it would make sense to at least see someone else and get another opinion (perhaps even another OPTION!) before going ahead and having him operate again.

Sharon

Re: question-surgery schedule for next week

Reb on 12/15/02 at 19:44 (103236)

I've had a second and third opinion. The first one had a pretty complicated theory (Baxter Nerve entrapment increasing peroneal activity causing the calcaneocuboid joint to sublux) which didn't really fit. The third guy agreed that the lateral band of the fascia was over burdened as a result of the pf surgery.

Re: question-surgery schedule for next week

Reb on 12/15/02 at 19:52 (103238)

I guess I didn't provide all the details but truly I am not going into this surgery half baked. I have done a ton of research, it's been my obsession for over a year. The whole tendon thing was my idea based on things I've read and my doctor went along with it far enough to order a MRI and go over the films with me carefully. He even called in another doctor to look at them and give his opinion. He agreed that there might be a slim possibility that something could be going on with the tendon but he doubts it based on the MRI.

Re: question-surgery schedule for next week

Dr. Z on 12/15/02 at 20:00 (103239)

It is the calcanel cuboid joint that is usually what is causing your problem. I will refer to an article I believe is on this web site by Dr. Downey. He talks about a fusion of this joint to stop the pain.
I would try to look for it

Re: Here is the article. came from this site

Dr. Z on 12/15/02 at 20:03 (103240)

Complications and treatment
Lateral destabilization problems, including calcaneocuboid syndrome, are perhaps the most common complications associated with the EPF procedure. As mentioned, avoiding or diminishing the risk of these complications by releasing less of the fascia would seem to be advisable. Further, a more restrictive postoperative course, including several weeks of limited or partial weight-bearing, a short leg walking cast, and/or night rest splints might diminish the frequency of these lateral column problems.
When the problem of calcaneocuboid syndrome does occur, it should be managed in an aggressive but conservative fashion. Barrett et al7 recommended that initial treatment consist of decreased ambulation and standing, stretching exercises, NSAIDs, orthoses, and physical therapy. If this regimen fails to alleviate the problem, they recommend a removable cast boot or referral to another surgeon experienced in the EPF technique, a pain management specialist, or a neurologist. In certain cases, where nerve entrapment or a potential chronic pain problem are possibilities, referral might be considered. However, in most cases, diligent continuation of conservative measures oriented towards the amelioration of inflammation and mechanical control of the calcaneocuboid joint will lessen or resolve the patient's symptomatology. I recommend orthotic management with a cuboid pad to help lock the calcaneocuboid joint, or a course of nonweight-bearing in a short leg cast for four to six weeks. Corticosteroid injections, NSAIDs, and physical therapy are used as adjunctive measures. As a last resort, in cases unresponsive to conservative treatment, calcaneocuboid joint arthrodesis or midtarsal joint arthrodesis may be necessary.25

Michael S. Downey, DPM, is professor and chairman of surgery at Temple University School of Podiatric Medicine in

Re: Here is the article. came from this site

Reb on 12/15/02 at 20:17 (103242)

Thanks, Dr. Z. I've read this also and showed it my doctor. I've gone through all the above conservative care: NSAIDS, physical therapy, stetching, cuboid manipulation, injections, rest, othodic adjustment, boot cast, then non-weight bearing hard cast for six weeks. The thing is that both the MRI and bone scan do not indicate a problem with the calcaneocuboid joint. It's all in the lateral band of the fascia. My doctor doesn't see that a joint fusion is going to help. I found something that you wrote while a doing a search on this site about going back in to release the lateral band after partial releases to treat lateral column pain?

Re: Here is the article. came from this site

Dr. Z on 12/15/02 at 21:00 (103245)

You can always go to the joint fusion if the lateral band release doesn't give you the LONG term relief you are seeking. Good Luck and keeps us informed.

Re: Well wishes

Sharon W on 12/15/02 at 23:08 (103253)

Reb,

It sounds like you have researched extensively, have gotten other opinions, have established trust in your surgeon, and have made up your mind! So, I wish you the best of success with your surgery and hope it will be accomplished with a minimum of discomfort.

And please do post to this board again afterward, to let us know how you're feeling. I think I got the wrong impression about where you were with respect to your treatment, etc. -- people sometimes do rush forward into surgery (where angels fear to tread).

Sharon

Re: question-surgery schedule for next week

t eiford on 12/16/02 at 09:58 (103280)

hi it sounds you are in the same boat as me,i went back to the dr this morning, he said my mri showed a lot of fluid and scar tissue and that he could not asure that he could fix the problem. do i do the 2rd surgery or remain in severe pain ?

Re: question-surgery schedule for next week

Pauline on 12/16/02 at 11:45 (103294)

You put your surgery on hold, gather all your medical records, including x-rays, MRI's and other tests, your first surgical report and seek a second opinion or opinions from other Pods and Orthopedic Surgeons who specialize in foot and ankle surgery. If you tried a Pod see what the Ortho says.

You also finish the homework you started by looking for more studies or abstracts that may help you define your condition. When you go for your next opinion or opinions go armed with all this material and your records.

What you don't want to do is rush into another surgery thinking this one is your sure cure. I have yet to see 'snowballing surgeries' help anyone. Just look at the surgical postings for proof.

You could almost say some foot surgeries are bibical because one usually begets another and that one begets the next until finally down the road the doctor tells you to seek your pain relief from a Pain Clinic.

Some people are afraid to cancel a surgery because they fear what the doctor will think of them or that he will get mad because they want another opinion.

Most doctors don't fear you getting several opinions and if they do then you really need a new one. Remember your in charge of your body do all your measuring (homework) before you let someone cut into it.

People in pain sometimes make poor decisions because they are in a hurry for relief. Remember there is no guarantee any surgery will make you pain free.

Re: question-surgery schedule for next week

Reb on 12/16/02 at 12:56 (103299)

Hi t eiford, What surgery did you have and where does it hurt? I know how hard it is to decide what to do when you're in pain.

Re: Well wishes

Reb on 12/16/02 at 13:44 (103304)

Thanks, Sharon. You weren't the only one to get the wrong impression which can only mean that I wasn't clear when I posted originally. It was late at night after a long day preparing and hosting a birthday party for my nine year old son while nearly incapacitated with foot pain... I've read many of your posts and recall people trying to talk you out of your recent surgery. Do you still feel that you did the right thing? I remember that you really trust your doctor. I feel the same way. He tried getting approval to go out of Kaiser for ESWT. I did years of conservative treatment before he even considered surgery. Truly this isn't as hasty or ill informed as it must have appeared to you. I will let you know how it goes. Thanks.

Re: question-surgery schedule for next week

wendyn on 12/16/02 at 14:18 (103306)

Tammie - do you have any comments on this thread?

Re: question-surgery schedule for next week

Ed Davis, DPM on 12/16/02 at 16:55 (103315)

Please see my post on the doctors board. Your problem should be handled conservatively.
Ed

Re: question-surgery schedule for next week

t eiford on 12/16/02 at 17:25 (103322)

Hi,i had tts/open fashia surgery in febuary of this year and all my pain is heal ,arch, shooting pain going up leg when walking,the doctor said the mri showed a lot of fluid and scar tissue, he said that some folks get 100 % inprovment and some get none ! he could not guarantee he out come but it was totaly my discion. so do i live with this pain or go for the gusto ineed to get my feet back somehow. i have lost my job over this had to take hushand off insurance. well thats enought chating if i have the surgery it will be on the 31 of this month.
trish

Re: Well wishes

Sharon W on 12/16/02 at 18:02 (103333)

Reb,

You do have a good memory! That was 5 months ago. But of course, my surgery was for TTS -- a different situation from yours.

Yes, I still feel that I did the right thing, having the surgery. I feel about 80% better than I did before the surgery, which I consider to be a good ('successful') result. (I was even able to make Christmas cookies this year!)

Surgery sometimes gets a bad rap on these boards, I think, because there are so many people posting here who did NOT have favorable results for their procedures. NOT that I think surgery is the first or the best or the easiest answer -- it should be the LAST resort, but in some cases it is necessary.

Sharon

Re: Trust Dr. Ed.

Tammie on 12/16/02 at 22:57 (103364)

I am sorry have not seen this but yes I would like to say a few things.
1,never make a decision about surgery when you are in pain!!! Pain first of all will make you do anything at all to get rid of it, even a second or third surgery!

Take a person who can hear for you and understand what is being said! Dont trust your own ears as remember you hurt so darn bad you will hear what you want!

If you are in pain and it is unbareable, Find a DR who can treat this and give you some good sleep and allow your memory to come back. Who can make a good decision when it is weeks and weeks with pain and no good sleep?

If this is your second surgery by the second Dr. be sure of what he is doing as a second surgery could work of course , but sometimes they do not work! You may end up like me or some of us here.

I found a pain management DR. I am the person who was healthy all my life no pills not even tylonol,ever.Said I dont believe in Drugs or drug therapy,Huh what a laugh,the only thing I ask myself is WHY did I suffer so long and Why did I have not 1 but 2 surgeries?

My answers are this, Lack of sleep major lack of sleep, pain that was not in a seperate spot it seemed to me that it was getting worse than better and finally I got some help and I will say yes I take a variity of meds,I am not thrilled about it but this is what I have learned from my pain Dr.s

The most important thing is give my self permission to take medication to help me feel better. First this is say if It was my heart or cancer or such ,and I had to take medications to live,then why allow my self to suffer in pain ? Ilearned as long as you follow what your Dr, plans of care is followed! You work at getting yourself to a point that you can function at the scale. The scale is of course a ten for tops doubtful,That I will see that but our goal is to get to a 4 and consider that a major advance! I forgot to tell you I now have RSD and it has been comfirmed by so many tests and alot of things and I am not sure if it was in any conection to the 2 surgeries or not but had I been able to retrace it would have been NO to either surgery and to find a Group of Dr.s to make a care plan of ME not my foot But ME ,I needed a group to help me with all that goes with chronic pain,I cant begin to tell you how it feels to have a good nights sleep with no pain,make it 2 and you might be able to see a future ahead! Please do what is best for you and yourself.

But Please take care of all of yourself and give yourself the right to find A Dr. or DRS to help make a plan of care not just surgery and bye ,I cant do more for you! I dont mean to say all Dr.s are like this but I found That pain sure does allow you to do anything that might take it away. Please be real sure of what you do!I am the flip side of surgery ,not healed but made my life a nightmare and not a few weeks or months,it feals life forever and maybe it is but i now trust my body to tell me what I need. I hope I dont say anything to frighten you or sound like I am not encouraging you, Please take time to take good care of you, I will never ever have me back. I walk with a cane and sometimes need a wheelchair, both of which I hate with a passion, but if I wish to get around I must do what it takes. Read about me if you choose , I had quite alot to deal with and I was hysterical at times .Forgive me , as I to was in those areas of pain and and more and no rest and no answers! Take care and I hope whatever you choose you will come back and let us know how things are going and know that we will be here to support you!!!

Good luck on the search of answers for your body and yourself!

Re: Well wishes

Sharon W on 12/17/02 at 07:02 (103375)

I should add that Dr. Ed, Dr. Wander, and Dr. Z are all excellent, caring, trustworthy professionals and I would take VERY seriously any warnings and opinions from them.

Sharon

Re: Pain meds ??

BrianG on 12/17/02 at 21:00 (103439)

Hi Trish and Reb,

I'd just like a second to tell you how fortunate you are to get all this advice, BEFORE the fact. Most patients end up here after multiple surgeries, when not a lot can be done. It's unfortunate, but there are so many nerves in the foot, the slightest mistake, or bad luck, and you could end up with extreme pain for many years to come.

Have you tried a pain management doctor, or clinic, until you feel you have 100% information you need to have that surgery. A good PM doc will start you out at a very low level of narcotics. You will barely know you are on the meds. He will slowly build you up, so that you can still work, if necessary. You'll also be able to sleep at night, which will give you a clearer head to make the best decision you can make. If not, you may feel rushed, as if there is no alternative, to have surgery that could give you pain much worse than you have now. Please don't think this can only happen to other people, this board is full of people who live in agony, people who rushed into something that really had no chance of curing them. Remember, a surgeon is paid to cut, thats what he does, and thats what he will usually recommend. Just ask him if he will guarantee his work !!!!

I pray you make the right decisions
BrianG

Re: Pain meds ??

t eiford on 12/17/02 at 21:28 (103443)

Hi Brian,thanks for the advise it is very good advice,if you read back a ways i did take your advice and went to a pain managment doctor and he said I needed to go to an expert doctor so he can try to undo the damage thats been done, gave me some lididerm patches and sent me away to this new doctor who put me back in air cast for 8 weeks ordered mri and all pre and post tests done before my surgery in feb. He said the mri showed alot of fluid and scar tissue, and all that he can try and do is go in and move the nerves and the chances were 60/100 some folks feel 100% and some get worse. told me to stay on the same medication that has done nothing but fry my 50 year old memory, he said that was the only med he would recommend for the burning and tingling.I see my primary doctor in the morning and we will talk about the surgery that is already set for new years eve day.I will keep you posted.thanks for replying. trish

Re: Pain meds ??

BrianG on 12/17/02 at 21:57 (103448)

Trish,

There are good pain docs, and then there are pain docs who should not even be practicing. Yours sounds like someone in the middle. A good pain doc will work with you, weekly if necessary, to ensure your pain is slowly getting under control. I believe you are in need of a pain doc who has compassion. Take a quick look at this web site: http://www.pain.com Near the bottom of the main page, there is a link to pain clinics in each state. I wish you luck.

BrianG