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I'm back again!!

Posted by Cherie on 12/31/02 at 14:21 (104404)

Hey Dr.s Zuckerman & Davis,
I bet you guys thought I got better and went away..not so. If you remember my case, I was having all the problems post-Ossatron procedure. I finally did go to another doctor. My podiatrist just threw his hands in the air and did not know what to do so he sent me to a pain mgmt doctor who immediately made me an appt with an orthopedic surgeon. I was still having terrible pain, numbness, burning, & tingling due to the nerve injury I sustained from the block done for my procedure. I was immediately put in a boot, which I had asked for for weeks and put on Neurontin which helps with nerve pain. I went to the orthopod and he said I could be developing reflex dystrophy from the injury, but it appears to be getting better. I am not experiencing near as much pain, I am off of most of the pain meds, but I still have burning, stinging, and numbness of the right toe, under the right toe and my arch. The joint under my toe is very swollen and numb. Have you guys ever seen anything like this?? How long do you think the numbness will last, it has been 7 wks?? I didn't ask my new doctor how long, I was just so freaked out when he told me about RDS that my mind went blank. My pain is so much better, but my foot seems to be the same. Any thoughts??? I'm feeling really scared and panicked. Cherie

Re: I'm back again!!

Cherie on 12/31/02 at 18:07 (104417)

I also forgot to ask the doctor if ice or heat was OK to use to relieve the stinging pain. I also wanted to try to swim to get a little exercise since I can't walk around. Since I am in the boot to protect my nerve, would swimming endanger my recovery?? I do not want to damage the nerve any more. Thanks so much again, you guys have been great to me. It's so hard to remember to ask everything while you are the dr office. Cherie

Re: I'm back again!!

Dr. Z on 1/01/03 at 21:17 (104504)

I really wish I could examine you but here goes. Any changes on with x-rays. I would order bilateral three view x-rays of your feet. I want to see if there are any bone density changes , one of the first signs of RSD.

If this RSD you have got to be very aggressive. My opinion is if it is you need to be on steriods, aggressive physical therapy including water therapy
with an epidural block

If the boot helped I doubt if this is RSD but still need to rule this out.
Typical RSD hurts more with immoblization.

It could take six months to one year to repair the nerve if there is damage. Some times it many be permenant.

Concerning your heel pain. I would go for the medrol dose packet. rest,
boot cast. Possible local steriod injection with physical therapy aquatic therapy.

Lets see did I leave anything out. Oh there was one case of nerve injury in the FDA studies I believe.

Re: I'm back again!!

Cherie on 1/01/03 at 22:25 (104514)

I have had a bone scan and an MRI with no abnormal findings. I am mainly doing desensitization right now which I elected to do at home. What causes the lump under my toe when the actual injury is at the tibial nerve?? These feet problems are so complicated, I have got to hand it to you guys. My pain is much less now than it was several weeks ago, its the numbness and the discomfort of walking on this golfball under my big toe. My doctor told me the main concern was to protect the nerve from further damage by wearing the boot which I mainly just wear at work since I mainly sit at home. Is it OK to take it off at home if I'm careful. Also, will ice or heat help? I'm still so upset that my podiatrist ignored me for 4 wks while prescribing drugs such as Percoset and Vicodin which are not for nerve pain. I just don't understand why he didn't put me in a boot or order an X-ray. I really feel he is negligent and I may have complications due to him ignoring me. You guys told me right away I needed treatment & everytime I called him he blew me off. Thanks so much for the information, it is so incredibly nice of you to take the time to do this...Cherie

Re: I'm back again!!

Dr. Z on 1/01/03 at 22:41 (104519)

I will still get the bilateral x-ray to see if there is a different in bone density at the big to joint. Yes the tibial nerve does have a branch to that area. Julie has information on a shoe for the shower. in her response. Don't jump to the permament damage yet. What I know seems like a life time seven weeks is really a very short time for nerves to heat.

Re: I'm back again!!

Ed Davis, DPM on 1/03/03 at 22:35 (104759)

Cherie:

Ice would be okay if you are dealing only with a nerve injury but can, at times, exaccerbate RSD or CRPS. Do you have any changes in temperature or color, swelling in your foot?

It is unlikely that swimming would hamper your recovery. It is something to do in moderation.
Ed

Re: I'm back again!!

Cherie on 12/31/02 at 18:07 (104417)

I also forgot to ask the doctor if ice or heat was OK to use to relieve the stinging pain. I also wanted to try to swim to get a little exercise since I can't walk around. Since I am in the boot to protect my nerve, would swimming endanger my recovery?? I do not want to damage the nerve any more. Thanks so much again, you guys have been great to me. It's so hard to remember to ask everything while you are the dr office. Cherie

Re: I'm back again!!

Dr. Z on 1/01/03 at 21:17 (104504)

I really wish I could examine you but here goes. Any changes on with x-rays. I would order bilateral three view x-rays of your feet. I want to see if there are any bone density changes , one of the first signs of RSD.

If this RSD you have got to be very aggressive. My opinion is if it is you need to be on steriods, aggressive physical therapy including water therapy
with an epidural block

If the boot helped I doubt if this is RSD but still need to rule this out.
Typical RSD hurts more with immoblization.

It could take six months to one year to repair the nerve if there is damage. Some times it many be permenant.

Concerning your heel pain. I would go for the medrol dose packet. rest,
boot cast. Possible local steriod injection with physical therapy aquatic therapy.

Lets see did I leave anything out. Oh there was one case of nerve injury in the FDA studies I believe.

Re: I'm back again!!

Cherie on 1/01/03 at 22:25 (104514)

I have had a bone scan and an MRI with no abnormal findings. I am mainly doing desensitization right now which I elected to do at home. What causes the lump under my toe when the actual injury is at the tibial nerve?? These feet problems are so complicated, I have got to hand it to you guys. My pain is much less now than it was several weeks ago, its the numbness and the discomfort of walking on this golfball under my big toe. My doctor told me the main concern was to protect the nerve from further damage by wearing the boot which I mainly just wear at work since I mainly sit at home. Is it OK to take it off at home if I'm careful. Also, will ice or heat help? I'm still so upset that my podiatrist ignored me for 4 wks while prescribing drugs such as Percoset and Vicodin which are not for nerve pain. I just don't understand why he didn't put me in a boot or order an X-ray. I really feel he is negligent and I may have complications due to him ignoring me. You guys told me right away I needed treatment & everytime I called him he blew me off. Thanks so much for the information, it is so incredibly nice of you to take the time to do this...Cherie

Re: I'm back again!!

Dr. Z on 1/01/03 at 22:41 (104519)

I will still get the bilateral x-ray to see if there is a different in bone density at the big to joint. Yes the tibial nerve does have a branch to that area. Julie has information on a shoe for the shower. in her response. Don't jump to the permament damage yet. What I know seems like a life time seven weeks is really a very short time for nerves to heat.

Re: I'm back again!!

Ed Davis, DPM on 1/03/03 at 22:35 (104759)

Cherie:

Ice would be okay if you are dealing only with a nerve injury but can, at times, exaccerbate RSD or CRPS. Do you have any changes in temperature or color, swelling in your foot?

It is unlikely that swimming would hamper your recovery. It is something to do in moderation.
Ed