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Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

Posted by Leah on 1/03/04 at 23:53 (141298)

I would appreciate any feedback from medical professionals regarding the wisdom of having EPF on both feet at the same time. I have been dealing with PF for the last 5 years. It has progressed steadily in spite of stretching exercises, 2 different types of orthotics (over the course of the 5 yrs), cortisone injections, ultrasound, and the last year in a night splint, only to have my feet so bad now that I can hardly walk around in my own house. My R foot now has pain not only in the heel, but also the arch, under my great toe, along the top of the metarsal to my great toe and have developed a very painful neuroma in between my 4th and 5th toes. Arthritis is setting into both feet and I am now developing bunions in addition to the PF. My entire R foot is now involved and a total wreck. From reading the emails that are posted, I can say that I have tried everthing conservative in the last 5 years except the shock wave therapy. I am desperate for help because I literally cannot walk without pain. I am 46 years old and have gone from being a very active, physical person to someone who can barely ambulate. The emails about recovery from EPF, however, are not encouraging...but I don't know how anything can get much worse at this point... Your feedback please...

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

Steve G on 1/04/04 at 01:50 (141301)

This may be a bit late, but I would strongly consider ESWT before I went with surgery. I am surprised that your pod will do the EPF without trying ESWT, first. Surgery is the LAST resort, and I, personally, would not consider it until I had a least two rounds of ESWT. The docs on this board will tell you the same thing.

I would pospone the surgery until I gave the ESWT a try. It has a higher success rate than surgery and none of the complications.

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

Julie on 1/04/04 at 02:25 (141302)

Please at least get another opinion from a different podiatrist before making a decision about any surgery, let alone EPF, let alone on both feet at once.

I am not a doctor, but from all I have read here over the past three years, it is not highly thought of as a surgical procedure for PF because the surgeon cannot see what s/he is cutting: there have been many reports of failed surgeries that left people worse off than before. I know Dr Z prefers Minimal Incision Surgery, but he rarely if ever performs surgery now, feeling that ESWT is a safer alternative, because it is non-invasive and is unlikely to harm even if it does not do good. You should certainly investigate ESWT, and, if you are deemed to be a candidate for it, have it before agreeing to surgery.

I'm sure there are EPF successes, too, but I would not want you to be one of the many failures. If you do decide to have surgery, don't have it on both feet at once unless you have 24-7 support from someone who can devote him or her self to your healing: You will be totally non weight bearing during the recovery period.
.

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

Bud P on 1/04/04 at 07:42 (141307)

Leah,
I had EPF surgery on my right foot almost eight weeks ago. I'm glad at this point that I had the surgery. My foot is 90% better and seems to be getting better everyday. I wish I would have done it sooner. The only thing I can tell you is, I would never have both feet done at the same time. It's difficult enough with one foot. The 3 or 4 days following surgery are trying times. I was able to get up and go to bathroom or kitchen with crutches and a boot,but if I would have had both feet done that would have been impossible.Do yourself a favor and have one foot at a time done if surgery is the choice you make.
Bud

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

Katy F on 1/04/04 at 08:48 (141315)

I just had surgery (12/19/03) on both of my feet at the same time. It was not that bad. The surgery itself is virtually pain free. It does hurt to walk.
My surgery was done under general anesetic. The Dr. said that the medicine used to numb them with will cause the surgery area to be cloudy and his vision will be blocked. Never felt a thing! He does numb them before you wake up and it can take over 24hrs for the feet wake up. So you cannot be left alone for a couple of days. Five days later he took off the bandages and I was back in shoes. It really has not been that bad. I still cannot tell how successful it was because they are not healed yet. They did not swell too bad, but they are bruised. I am now in an elastic bandage
which in my opinion has caused some pain(only at night) since they are tight. My walking is getting better everyday.
I would suggest a walker and a wheelchair. I use my wheelchair if I need to go somewhere(grocery store and work) and have very far to walk. Good luck with your surgery. By the way, my Dr. never suggested the shock wave treatment. Everybody's feet are different and it may not be for you.

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

BrianG on 1/04/04 at 11:01 (141327)

Hi Leah,

I am not a medical professional, but I'd like to throw in my 2 cents, as I had a failed EPF operation. Has your doctor told you what to expect if something goes bad during the operation? Has he told you about RSD, or other nerve related injuries?

I know that you think you cannot tolerate any more pain, but from reading these forums, I can tell you that is not true. If your operation has negitive side effects, you could be in much worse pain, possibly for life !!!!

Good luck, and please ensure that you have all the facts before going under the knife. Once your cut, there is no going back!!
BrianG

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

Dr. Zuckerman on 1/04/04 at 12:36 (141333)

I would use ESWT regardless if my insurance did or didn't cover the procedure. When I did pf surgery, I only did one foot at a time. The results can be very poor when doing both feet. Pf surgery has some very serious complications when things go wrong.

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

Rose on 1/04/04 at 14:45 (141342)

I had the surgery on both feet in July and am very glad I did both feet att he same time. It was faster healing since I could not walk on either foot for a while, at least I shouldn't. I spent a lot of time with my feet up and with ice behind my knees ond on my feet. I used a wheel chair for the first month and then only when I was out for a while. I am very glad I ahd the surgery and had both feet done at once.

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

Dorothy on 1/04/04 at 16:19 (141348)

BrianG ~ I just want to say thank you for your always helpful and smart posts to people. I like how you seem to really 'listen' to people and speak directly to them - but as one who reads what you write, I also am helped by what you are saying to someone else. So, thanks. And I hope you have a happy and healthier new year. You never know what new information is coming down the pike. I read this while waiting in line at the grocery store (a magazine on the nearby shelf):

Unexpected Blessings

Give thanks
For unknown blessings
Already on their way.
-Native American Prayer

I thought it was a nice, HOPEFUL statement.

Best wishes.

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

Dr. Zuckerman on 1/04/04 at 21:12 (141377)

I have done single pf releases and bilateral pf releases. It is very rare to have results like Rose's. I have found that calcaneal-cuboid syndrome is a complication that occurs in bilateral cases more often. Rose glad you are doing well.

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

BrianG on 1/05/04 at 19:14 (141446)

Thanks Dorothy, I must admit that what I wrote above didn't exactly come from reading the forums. A big part of it came from talking with Tammie, and a couple other patients, who had surgery gone horribly bad. At this late date, I don't think anything we said was going to make a difference, but just maybe someone else will read this, who is about to let their doctor talk them into unnecessary surgery. I hope her surgery went well today, and that she has caregivers available that will allow her to be off her feet.

Regards
BrianG

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

Charles G on 1/06/04 at 21:47 (141524)

Brian,

Tell me about your failure and what symptoms you have now? I had epf 3 months ago and am not sure if I am in 'normal' recovery or have other complications as a result of the surgery. Help me out with RSD? What is it? I was not informed very well by my POD and as a result may have jumped on the epf too quickly. I was told I would be pain free in 4-8 weeks and like an idiot didn't get a 2nd opinion. My fault. Too late to reverse it but any information would be appreciated.

Thanks

Charles G.

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx

BrianG on 1/08/04 at 22:18 (141661)

Hi Charles,

First, you have to realize that everyone heals at different rates, just as we all all perceive pain differently. I had my EPF just before I found this forum. After reading here, I'm pretty sure I would not have gone ahead with the surgery, if I knew some of the possible complications. I had very bad pain for the first month, but no infection, as I made the doctor give me a script for antibiotics. I don't take them very often, and I thought it would be good insurance. The 2nd month was also painful, but not quite as bad as the 1st. During the third month, the surgical pain started to subside. At no time did the PF pain ever get better though. I finally went back to work, during the 4th month. My job involved sitting for about 5 hours, then walking tours (Security) for 3 hours. It didn't take long for my original heel, but also the 2nd heel, to start hurting worse than ever. I favored the surgical foot so much after the operation, that I developed PF in the good foot as well. I stuck it out for about a year, then finally had to quit, and apply for SSD.

RSD is short for Reflex Sympathetic Dystrophy. It's a nerve disorder that is usually brought on from some type of trauma to the nerves, usually in the extremities. With PF, it usually starts in the feet, but can also spread to the legs, and even further. It's very difficult to treat, especially with opiates. It just doesn't respond as well to them (opiates), as other types of pain meds. You may want to see a Neurologist, who is the doctor who typically threats this disease / injury. Unfortunatly the Neuro's do not have very many effective meds to treat RSD. They use meds, developed for other types of treatments, off lable, with the hopes of treating the RSD pain. Pain clinics also treat RSD, with Methadone being one of the best nerve type opiates.

There are some good websites you can check out. One of them is http://www.rsdhope.org . There is also another good one on the message boards hosted by Mass Gen Hospital in Boston. It's a very active board, attracting patients from all over the globe.

Regards, and good luck,
BrianG

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx to Charles

Bud P on 1/11/04 at 14:21 (141824)

Charles,
I noticed you mentioned you had to apply for disability. I'm just curious. Were you able to get disability? Having PF is a very disabling condition and I just wonder if SS recognizes it as condition to award disability.

Bud

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx to Brian.

Bud P on 1/11/04 at 14:23 (141826)

Brian,
My post to Charles was intended for you. If you can read it and let me know. Thanks, Bud

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of conservative tx to Charles

Pauline on 1/11/04 at 14:25 (141827)

Bud,
If only we could get employers, SS and others to realize this condition as a disability.

Re: Having EPF on 1/5/04 on BOTH feet after 5 years of to Pauline conservative tx to Charles

Bud P on 1/11/04 at 14:31 (141828)

Pauline,
I was already awarded disability due to some other conditions. I must say that the PF is worse than my disability.