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Am I the surgical winner (loser?)

Posted by Messed up foot on 3/01/05 at 09:55 (170199)

Pain started in July of 2004 and podiatrist & neurologists just patted me on the head and said - keep walking. So I did. Ended up with a stress fracture that lead me to an orthopedist and my series of surgeries. I actually walked all over San Fransisco with TTS, cuboid fracture, torn tendon and plantar fasciitis. Can we all say 'stubborn'? I also have a pretty high tolerance for pain, I guess. I assure you, it hurt! EMGs normal, MRI showed cuboid fracture but no tendon or TTS issues. 'Mild' fasciitis noted with a large heel spur.

After 2 weeks in a cast for the fracture, the pain was unbearable on both sides of my heel. Ortho diagnosed a peroneal tendon tear when you could feel, see and hear the tendon snap over the lateral maleolus. I took 2 weeks for the swelling to subside enough for the diagnosis.Had peroneal tendon repair 12/7/04 and was just starting to walk (if you can call it that!)when ortho said that the reason the tendon tore was TTS and plantar fasciitis. He was concerned after 2 cortisone injections that the TTS was unresponsive (heel numb, big toe intermittent numbness/tingling) and that the tendon would tear again if I stepped down wrong on the numb heel. Had TTS and partial plantar fasciectomy on 2/15/05 and I'm still no weight bearing and in a cast. Hope to have the cast off tomorrow and get the blasted staples out!

My comment/question - pain. It's worse now than before the surgery and my heel check (used a ruler in the cast - and yes, I know that was a no-no) found that the heel is still numb. Talk about a disappointment! I feel like a whimp that I have only been off narcotics for 1 1/2 days. Tylenol doesn't cut the pain but I'm sick of the side effects.

I'm sort of wondering if my very qualified foot/ankle surgeon was a little too eager to cut. I have to go back to work this week unless I can talk the surgeon into extending my leave and it is a little frightening since I am still so limited physically and by pain.

Oh - forgot to mention that when I could last see my foot - it turns colors too. Purple until I massage it, then it returns to a normal shade. Anyone experience this?

Sorry this is sooooooo long - it's been quite a journey!

Re: Am I the surgical winner (loser?)

Dr. Zuckerman on 3/01/05 at 12:12 (170212)

Hi
You have major foot surgery. It can take months even up to one year. Numbness could be from swelling and or numbness damage. Time will tell you this one six months from now. The color changes should be address and discussed with your orthopedic doctor. Must make sure you don't have RSD starting. Time to see your doctor and have an examination and discussion about healing. It take six months to one year

Re: Am I the surgical winner (loser?)

Fed Up Also..... on 3/01/05 at 12:58 (170213)

Welcome to the unpredictable world of podiatric (or voodoo / money grabbing) medicine.

Re: Am I the surgical winner (loser?)

Dr. Zuckerman on 3/01/05 at 13:26 (170214)

Hey Fed up
This was a surgery done by a orthopedic doc. Do you want to include this profession also?

Re: Am I the surgical winner (loser?)

Messed up foot on 3/01/05 at 13:47 (170216)

Let's all be nice here! I'm a nurse and have researched all of these procedures prior to agreeing to them! Ortho might be a little knife happy but I chose to go ahead with the TTS surgery. No one wants to have the peroneal tendons tear a second time! It is very painful. Podiatrist also was ready to do the surgery. Let's face it, docs trained to perform surgery typically enjoy doing it.

I am very worried about RSD - PT commented that she was worried about the vascular changes as well and that was before surgery #2. I have the color change and feel cold but with 2 surgeries in 10 weeks, it goes without saying that things still hurt. After the tendon surgery, I was off pain killers in 3 days. TTS surgery seems to be alot more painful to me plus I was in the minority of folks who have a variant pathway for the calcaneal nerve(s). Ortho referred to the procedure as requiring 'a lot of dissection'.

Re: Am I the surgical winner (loser?)

Fed Up Also on 3/01/05 at 16:02 (170224)

OK, if you want to...............

Re: Am I the surgical winner (loser?)

Dr. Z on 3/01/05 at 20:15 (170240)

If you have any concern about RSD as you know early treatment is a must. See a pain management specialist for a possible epidural injection

Re: Am I the surgical winner (loser?)

Messed up foot on 3/02/05 at 16:32 (170310)

Thanks for your advice. Ortho wants to wait since I have a lot of swelling and a whopping 7.5' incision. Two more weeks to wait, I guess.

Re: Am I the surgical winner (loser?)

messed up foot on 3/11/05 at 11:59 (170950)

Well, it's been almost 2 weeks in a cast (NWB) and I had to return to work (desk job). Toes are purple and edematous unless I keep my foot up on my desk. That sure looks nice and professional! Why are we told that we can return to work in 2 weeks after surgery? It isn't very realistic and it screws up sick leave. Ortho's only advice is to keep my foot up. So I do.

TTS incision is pain free which is sort of surprising buth the partial plantar fasciectomy hurts like hell. My question - heel remains numb but I have a lovely new pain in my arch and under the cuboid bone (remember, mine was fractured so I am sure of the location). Is this referred pain or something new and different? I also have throbbing pain at the base of my long TTS/PPF incision and the very point where my tissue was too thin to support a staple closure and sutures were used. Cast comes off in 5 days - I can't wait!

Re: Am I the surgical winner (loser?)

messed up foot on 3/16/05 at 17:46 (171347)

Cast is off and the incision looks great! Lots of swelling yet (my personal hell) but the minute I put on the camcast, I could walk again! Yes, it is still uncomfortable (like a strong ache) and yes, I am still not wearing a shoe, but there is a light at the end of the tunnel.

I'm not sure that I would have PF surgery again - but since I have TTS in my right foot too, I won't think twice once it is time. Arch is pretty darned sore but maybe that will improve when the swelling goes down.

Thanks to all for the chance to sound off!

Re: Am I the surgical winner (loser?)

messed up foot on 3/24/05 at 15:35 (171897)

A milestone achieved! No one without PF and TTS would know how exciting this is. Five weeks postop, I tolerated a shoe for one entire hour and I was standing/walking on it the entire time. I still have no feeling in my heel and the bottom 1/3 of my incision (thus allowing me to tolerate the shoe?) Any contact, even just applying a scar reduction cream, with the upper incision leads to tingling toes so I assume that things are still fairly irritated from the surgery. Wearing a real shoe after 4 months in a cast or camcast made me feel like I am finally getting better. Unfortunately, once my foot heals, I get to address a herniated disk. My orthopedic clinic should name a wing after me!

I did find a pain killer that works great - Voltaren! It's inexpensive and one of the older prescription NSAIDs. Tylenol, ibuprofen and even oxycodone does nothing to cut the pain but with this one, I stood for 4 hours in the camcast and was 100% pain free. Just a suggestion for those of you with intractable aching. I was shocked by how well it works!