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Last Resort Surgery

Posted by Kara S. on 12/03/03 at 19:58 (139292)

I've seen many posts advising surgery only as a 'last resort'. At what point does one realize surgery is the only hope? How many and what alternatives should be tried first? How much pain is too much. I keep asking myself 'am I just being a big baby about the pain?' or 'is there something I should try that no doctor or medicine has helped yet?' One can become paranoid when one lives with constant pain that others around me can't feel, see or understand. You know, if I had a broken arm bone sticking out of my arm, people would say, 'gee, that must be painful', but with TTS symptoms - it doesn't show. Any suggestions?

Re: Last Resort Surgery

Dorothy on 12/04/03 at 00:12 (139311)

Those are excellent questions, Kara S., although I am sorry that you apparently have pain that causes you to even have these questions. It might be helpful if all the good minds here could help you - and everyone - come up with a 'decision tree' as they are called that one could use as a guide to make these difficult decisions about 'last resort' treatments. You can sort of deduce many or most of the so-called conservative treatments from the discussions here, but how long to try them? and how many? all? These are excellent questions. I would ask you - are others doubting the severity of your pain and so making you doubt the severity of it yourself? What is YOUR answer to your question: how much pain is too much? It is a question whose answers would be unique to each person - it's called 'pain threshold' or 'pain tolerance.' What do YOU think? Is YOUR pain 'too much'?? I almost think one of the key questions is: is the pain so bad that I AM willing to risk having a surgical result that causes greater pain, permanent pain or some other worse outcome. THAT might be the deciding point. What do you think?

Re: Last Resort Surgery

Julie on 12/04/03 at 02:32 (139316)


I recall reading a number of times that TTS surgery has a low rate of success (60% has been states several times) and is likely to be successful only when there is an identifiable mass in the tunnel that can be removed. Is this the case in your case? Even then, there is the distinct risk of nerve damage and other 'side effects'. So it is a decision that requires a great deal of thought - and firm knowledge about what is actually going on inside your foot.

You don't say anything about your condition: how long you've had it, whether or not you're happy with the doctor who is looking after you, what treatments have been tried. 'Last resort' means different things to different people (even different doctors!). I feel that the most important factor is an able, knowledgeable, caring physician whom you trust and who really will 'try everything' and it is from him or her that you should seek this advice.

Perhaps you should post your question again on the 'Ask the Doctors' board, this time with more information to help them give a considered response. I honestly don't think people's opinions are going to be of much use to you. Even if you hear from someone who has had the surgery, their case is likely to be different from yours.

Re: Last Resort Surgery

Aly on 12/04/03 at 08:25 (139329)

I think for each person it's different - for me, 'last resort' will be when I decide I am desperate enough to risk my feet for good - when I feel there is no hope of my feet ever healing on their own, and that I have absolutely nothing to lose. I never want to look back and realize I made a mistake in having surgery, that it caused more harm than good (worst case scenario). So, I'd probably have to be suffering for 7 or 10 years before I'd consider it. But as I said, it depends on each person - only you can decide when you've reached that point...

Re: Last Resort Surgery

RonB on 12/04/03 at 17:37 (139365)

I agree that a last resort is up to the person. For me it was 2 years, however, I also have 8 pages of document treatment history.

I suppose as I began to miss work it became more urgent to see results more quickly.

Pain is also a great driver. I would include a pain management specialist in you list of treatment before surgery (I did not and wish that I would have).