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Very Depressed...WANT surgery

Posted by Michele on 7/11/05 at 17:53 (178194)

I have had heel pain for about 4 years now. I am only 24 years old. I have tried everything from icing, meds (Celebrex, Ibuprofen, Neuronton (sp) etc.), physical therapy, walking boot, orthodics, stretching, night slpints, full cast for 2 months, coritisone shot....and nothing has worked. I have even had an MRI and a bone scan. The bone scan showed a lot of bone damage.

I am to the point where I give up. My doctor (mind you, I have had about 25 different doctors) is so quick to give me meds and push me out the door. I can't believe I wore a cast for two months and if anything it made it worse. My pain is now going up the back of my ankle. My foot is very very inflammed. I cannot wear shoes because the pressure on the back of my ankle hurts so bad. My doctor told me that I have a small case of joint disease, but that it is normal!

Has anyone been through what I am going through. He decided that he wants me to take an oral steorid which I will not do. I now have stomach problems because of the meds I have to take in order to walk. I cannot do anything.

I am so depressed that I may lose my job, my boyfriend of 3 years and my friends beacuse this is consuming my life.

Can someone PLEASE give me some suggestions? I told the doctor to cut the darn foot off! I really want the sugery and hope my doctor will let me have it. Even though many people are skeptical I am willing to try anything at this point.

Thank you in advance for any advise or suggestions you can offer me.

Michele
(email removed)

Re: Very Depressed...WANT surgery

Ralph on 7/11/05 at 19:34 (178204)

Michele,
Sorry your feeling sooooo bad and hurt soooo much. If you do a search on Scott's board under the Search Tab you'll find many others who's posts are very similar to yours.

Constant pain is very depressing and from reading this site depression seems to become a reality that many have had to be treated for. If you are really feeling depressed seek help in that area.

If you really want to have surgery, finding a doctor to perform it can be done. What you need to understand, however, is that not every surgery performed leaves the patient pain free.

Personally I think you are lucky that your doctor isn't rushing you under the knife, but only you can made the final decision. Stick with your present doctor or find one that will fill your desire to have surgery.

When you use the search tab to read back posts you'll find that others posted that they did lose their jobs or were forced into a new career that kept them off their feet. Many cancelled vacations and some had to get family and friends to help them do even the littlest things.

What I'm trying to say is that people tried their best to cope with this very bad situation and it wasn't easy and for many it still isn't easy just as it isn't easy for you. All anyone can ask of themself is to try their best and seek help. It sounds like you are doing that already so I think you are on the right road.

As far as losing your boyfriend, I'm sure Dr. Laura or Dear Abby would tell you not to worry. You can't make someone stay around when they want to leave, but I think it certainly is a measure of how much they really care for you. When choosing a mate you want one that will be there and support you in good times and in bad. Better he should walk now than after your married and have children if your thinking about that.

You can easily turn this part of your situation from a negative to a positive by merely changing your thinking. Your not the problem. You merely got a bad case of P.F., and this test is giving you a chance to learn a little more about your boyfriend. It's quite possible he's providing you with a preview of himself, life with him, and how he handles difficult situations. If you end up spending your future together can you count on and expect understanding and support or does he walk everytime you get sick or experience difficult times within the marriage? They say actions speak louder than words.

This is the same advice I'd give to my daugher. Love with all your heart, but keep your eyes open so you can see the reality in every situation.

Re: Very Depressed...WANT surgery

Orfie on 7/11/05 at 22:27 (178213)

Hi Michele, I understand your heel pain. I only lived with the pain for a year because my doctor wanted me to try all other alternatives like, icing, taping, physical therapy, shots, etc. Since nothing worked, my last resort was EPF surgery. It's now a little over two months since the surgery and I feel great. I still have some slight pain in the foot but with time I believe I will be pain free, I am getting back to normal. I still have to continue to ice and stretch.
I strongly recommend surgery. I know some people would never do it. My doctor had a talk with me and he told me I was a good candidate for the surgery and I ask hime a lot of questions. My docotr has done many PF surgeries and I felt confident. Talk to your doctor and tell him what you want and if he can't do it ask him for someone who has done this type of surgery. I live in Chicago and I would refer you to my doctor. Good luck and keep me posted. (email removed)

Re: Very Depressed...WANT surgery

Donna Taylor on 7/12/05 at 12:32 (178248)

I felt as though I just read about my life. I have tried everything that you have and I finally have a surgery date for 7/29/05 and then after I heal from my right foot they will do my left if everything goes ok.

Re: Very Depressed...WANT surgery

Sally on 7/12/05 at 23:25 (178288)

Michele:
You are too young for all this. What kind of bone damage did the MRI show?
Have they considered CRPS?
Sally

Re: Very Depressed...WANT surgery

goose on 7/13/05 at 10:53 (178318)

Hi Michele,

I'm sorry to hear what you are going through! Please make sure you are evalauted for RSD ( same as CRPS) before surgery as that could make it worse. I have RSD but am having great succes with the blocks and meds. Good luck!

goose

Re: Very Depressed...WANT surgery

Ed on 7/16/05 at 00:51 (178498)

If you have the surgery, be aware it is irreversible and if it does not work you will be in pain for the rest of your life.

Re: Very Depressed...WANT surgery

Ralph on 7/16/05 at 11:07 (178515)

I'm not certain that anyone knows for certain, or can be 100 % pure positive, that a failed PF. surgery means that someone will be in pain for the rest of their life. They MAY have pain but be 100% guarranted for a lifetime I think anyone really knows for sure.

What we do know is that complications may occur following any surgery. The extent and type of complication and whether they are repairable cannot be predicted with 100% certainty.

Re: Very Depressed...WANT surgery

Dr. Z on 7/16/05 at 13:56 (178522)

Ralph,

I had a work man come to visit my office for repair of my central AC. As he was walking around my office he was only walking on his toes. It was strange . I asked him what happen. He told me he had heel spur surgery years ago and they cut the nerve in his foot and this is the result. He didn't appear in pain but he was walking on his toes the entire time. He actually was moving pretty good. Was he in pain. He wouldn't talk about his foot at all. He wanted to only concentrate on his work.

Re: Very Depressed...WANT surgery

Ed Davis, DPM on 7/21/05 at 21:09 (178814)

Raplh:
Nothing is guaranteed in medicine. But if one cuts a vital structure, the plantar fascia, a structure designed to support the foot, the lack of support often causes pain in the midtarsal joint. There are usually consequenences to cutting vital structures.
Ed

Re: Very Depressed...WANT surgery

Ralph on 7/21/05 at 22:12 (178822)

Dr. Ed,
You know that and I know that but if a poster makes the decision to go forward with surgery its nice to offer support for their outcome.

When doctors stop doing the surgery there will not be any more posts from people deciding to have them done.

There is an elite group of doctors known as Retina Specialist. They are the only doctors in charge of the back chamber of the eye when it comes to surgery. They are highly qualified to perform vitrectomies a type of surgery that carries a list of risks one of which is blindness.

Trying to find one that will perform this surgery on a patient without good cause, namely to save vision, is more difficult than having a cow jump over the moon. They just don't do it regardless of what the patient wants. Their answer is NO.

There is no reason in the world that doctors who perform P.F. surgery couldn't do the same thing, but they are not willing to stand by their conviction. They are still willing to put a patient at risk in spite of knowing all the consequenences you listed in your post.

So when doctors stop doing the surgery that they know carries sooo many risks I'll not need wish success to the people that decided to have the surgery.

Re: Very Depressed...WANT surgery

Ed Davis, DPM on 7/21/05 at 23:06 (178828)

Ralph:
It is great to offer people support but far better to make sure that they realize that there may be better alternatives and to help them make sure they are not making a poor decision. The most important thing we can do here is to inform patients of the alternatives that exist to plantar fascial release surgery which may be better. All too many times such posters are not told by their surgeons that the success rates for surgery are not high and that alternatives such as ESWT do exist. I make a lot more money on plantar release surgery than on ESWT. But some of us out there need to place our convictions ahead of financial interest with our only reward being that we can sleep better at night and have G-d know that we have done the right thing.
Ed

Re: Very Depressed...WANT surgery

Ralph on 7/22/05 at 08:41 (178838)

Dr. Ed,
I think the doctors that are cutting off patients toes for cosmetic reasons
should be the first to sit in your classroom. Like doctors performing P.F. surgeries they too can say NO.

Both types of surgeries are being done by your colleagues yet no one stands up at your medical conventions and says 'This has to stop. We have a new policy. We are not doing these surgeries anymore' Why not place more restrictions on the doctors so they stop?

Just because ESWT is around is no guarantee that doctors will place their convictions ahead of their financial interest. Stop the P.F. surgeries and they will have to.

Re: Very Depressed...WANT surgery

Observer on 7/22/05 at 14:18 (178851)

Have you ever heard of market forces? Doctors do this kind of surgery because there is a demand for it, however stupid, and there is money to be made out of it. Individual doctors may obey their convictions, but as long as there is money to be made within the system, things will not change.

Re: Very Depressed...WANT surgery

Ralph on 7/22/05 at 15:11 (178854)

No kidding.

Re: Very Depressed...WANT surgery

Dr. Z on 7/22/05 at 18:44 (178864)

I have never heard of toe amputation for making smaller feet. Can any one tell more with very specific information which doctor is doing this. I bet no one can come up with the name of this phantom doctor.

Re: Very Depressed...WANT surgery

Theresa on 7/24/05 at 17:59 (179005)

I was misdiagnosised for 15 months. So, first I would make sure they knew what was wrong. Do you live near any major medical centers? I was even misdiagnosised by the Chairman of Orthopeadics at one of the top 10 medical centers in the country. Finally, a doctor figured out it was a nerve entrapment.

Re: Very Depressed...WANT surgery

Dr. Z on 7/24/05 at 19:26 (179006)

Just a though. Sometimes the entrapement is difficult to diagnosis and only after advancing in degree of pain, type of disability can the diagnosis be made. This is a art not a science

Re: Very Depressed...WANT surgery

Ralph on 7/24/05 at 21:18 (179007)

Theresa,
Did you have treatment already or are you still deciding on what to do?

Re: Very Depressed...WANT surgery

Ed on 8/18/05 at 19:41 (180744)

Ralph,

I stand by what I said.

Re: Very Depressed...WANT surgery

Ralph on 8/18/05 at 19:55 (180747)

Sorry, but I forgot what you are referring to.

Re: Very Depressed...WANT surgery

Joe M on 8/24/05 at 15:04 (181122)

Michele,
Until people have experienced acute foot pain they will never really comprehend your situation. As with many people who post messages on this site they have experieneced similar situations to yourself.

My personal experience was silghtly different from yours as my pain developed very quickly and was so acute that I could not apply any pressure to the right foot. Basically, I had gone from being a very fit person to a virtual criple over night. I visited the doctors surgery and hospital seeking help but there response was 'give it time to rest and it will heal'.

The eventual diagnosis was that I needed metatarsal correction of the lesser toes. The eventual diagnosis was some two months after the original pain started and thus by the time I had seen a surgeon of any merit depression had well and truely kicked in.

I was in some state prior to the surgery and for that matter some time after but as the old saying goes 'time,... is natures best healer'. What you need to do is breakdown the problem into two main areas, one being the foot pain and one being the depression you are experiencing.

I note from your comments that you have seen several doctors since your pain started. Are they all giving the same diagnosis or is there dis-parity between them. Before you under go any surgery you must be confident with the surgeon who is going to perform the operation. As you are in a depressed state your communication levels may not be as effective as normal when talking to the doctors. Before your next visit make a list of questions and write down the answers as he gives them. Suggested questions:-
1. To qualify for surgical intervention what pain levels/duration would you expect from the patient. Write your answer down to this question eg:-
Cannot stand for more than 2 hrs. Score your pain levels out 10. 10 being the worst and 1 being the least.

You must be strong with these people. Alot of patients treat the surgeons like gods but they are not and they can also be wrong. If you feel that your confidence levels are not good as normal, take someone with you who has both good comunication skills and lots of confidence (not easily intimidated). A parent may not be the best option as they are also emotionally involved with the situation.

As your depression is related to your pain once you have received the appropriate care this will soon pass. Remember your 24 years of age, losing anything at this time of life can be easily replaced. You have lost some self confidence at this moment in time but when you are better (you must believe that statement) you will return to your old self and once again the world will be at your feet.

Re: Very Depressed...WANT surgery

Ralph on 8/24/05 at 19:29 (181142)

Joe,
Your response is one of the best that I've seen here. Just terrific.

Re: Very Depressed...WANT surgery

Joe M on 8/25/05 at 15:42 (181195)

Ralph,
Thanks for the response. I note from the other posted comments that you have been discusing the options available for this type of condition. If, I am interpreting the comments correctly your correspondance are both surgeons. If this is the case I'm extermely alarmed at there comments and opinions on the surgery option.

One would have thought that there ethical stance would be beyond question given there training and standing within the community. ED Davis DPM appears to find salvation in the fact that he would not conduct the surgery without the correct circumstances being evident. But he either knows of,.... or has heard of,...... colleaques of similar stature preforming the surgery with only financial gain in mind.

If this is the situation, Mr Davis is as much responsible as the individual conducting the surgery. I am a professional in my own field (Engineering)and thus, have a similar responsiblity to the afore mentioned Doctor. My interpretation of this position is to ensure both my work and that of my colleaques is within the referentials set by the relevant governing body.

I appreciate the situation can be extermely difficult to deal with however, my train of thought is that any engineering structure passed off by myself would be sufficiently safe enough to carry your nearest and dearest, in my case, daugther and wife.

Next time Mr Davis you experience or hear of a so-called fellow professional conducting a large amount of epf SURGERY, ask yourself the above question but,... replacing the structure with operation. You have a duty of care for your community, not just your patients.

Re: Very Depressed...WANT surgery

Ralph on 8/25/05 at 22:50 (181212)

Joe,
I'm a bit confused by your first paragraph addressed to me in your post.

'Ralph,
Thanks for the response. I note from the other posted comments that you have been discusing the options available for this type of condition. If, I am interpreting the comments correctly your correspondance are both surgeons. If this is the case I'm extermely alarmed at there comments and opinions on the surgery option'.

The third sentence above is throwing me off. Are you saying I'm promoting surgery???? I don't see that printed in any of my posts this thread.

I don't understand what I posted that upset you, but I'd surely like to clear it up and correct anything that I said that was harmful.

Re: Very Depressed...WANT surgery

Joe M on 8/26/05 at 13:29 (181236)

Ralph,
Nothing you have posted has upset me,.... completely the opposite actually,.. virtually everything you have posted on this thread is spot on.

I took exception with the comments made in the below paragraph. Dr Ed appears to have his ethics in order but suggests other colleagues within the same profession may select the surgery option based purely on financial gain. My comments were directed soley at the professionals who perform surgery for financial gain.

I don't know about you but,... the mere thought makes my blood boil.

Ralph:
It is great to offer people support but far better to make sure that they realize that there may be better alternatives and to help them make sure they are not making a poor decision. The most important thing we can do here is to inform patients of the alternatives that exist to plantar fascial release surgery which may be better. All too many times such posters are not told by their surgeons that the success rates for surgery are not high and that alternatives such as ESWT do exist. I make a lot more money on plantar release surgery than on ESWT. But some of us out there need to place our convictions ahead of financial interest with our only reward being that we can sleep better at night and have G-d know that we have done the right thing.
Ed

Re: Very Depressed...WANT surgery

Ralph on 8/26/05 at 14:45 (181240)

Joe,
Thanks I'm happy to know that. If the surgery isn't provided there can't be any complications from it or financial gains. Patients can't perform it on themselves.

I think a doctor can stop performing any procedure they want. I don't think there is any law on the books that says because you know the procedure you have to do it.

There are Gynocologists that refuse to perform partial birth abortions. Although that's a different issue their ability to say NO comes through loud and clear.

Re: Very Depressed...WANT surgery

Joe M on 8/28/05 at 06:17 (181294)

Ralph,
You are obviously very much against heel spur (Plantar release surgery). Are you basing these comments on personal experience or making a judgement on the comments made from other posters.

Re: Very Depressed...WANT surgery

Ralph on 8/28/05 at 12:11 (181309)

Joe,
After all the reading I've done here and on the internet about P.F. surgery the last thing I'd ever do would be have someone cut my plantar fascia. It's plays such an important role in the support of the foot and when it's cut the foot cannot remain the same.

I firmly believe that in such tight quarters as feet where you have so many bones, tendons, ligements, muscles and nerves that need to work together that any change to one effects the other.

Personally I'd like to see this surgery stopped and follow up to patients who have had this surgery by state medical boards.

I honestly believe that some doctors perform the surgery for financial gain, and with poor training and thus they have little regard for the patient or the stibility of their feet afterwards. To them orthotics are suppose to provide the magic that will remove the pain from a botched up P.F. surgery.

They know the difficulty in proving malpractice and that pain clinics are their best friend when all else fails.

This is my take on P.F surgery. What is yours?

Re: Very Depressed...WANT surgery

Joe M on 8/28/05 at 13:50 (181312)

Ralph,
Following surgery to a fore foot birth deformity, 4 years ago, I now am experiencing difficulties with the P F in my right foot. I agree with your comment regarding knock effects of foot surgery however, I had no option but to take my chances with the operation.

Since the Op, the recovery period has been long and hard with reasonable result given the risks. The surgeon clearly defined all the possible problems with the surgery and left the final decision with me. Did I make mistake taking the operation,.......NO, have my feet returned to a condition were I can enjoy life as before the problems started ,...No.

It is all relative to what pain your in prior to surgery, for me this level was 11 out of 10. At the moment, the PF problems I'm experiencing presently are no were near the problems I had prior to my foot surgery and hence would not entertian surgery. However, if this problem accelerates into a higher pain rating I again might have few options but to opt for surgery.

As coincidence would have it, I saw my foot surgeon last week for the problem, his comments were as follows,:-
1. Problem should cure it's self within 12 to 18 months.
2. Injection of steriods.(Had this one last week,... ohhhh)
3. Ultra sound treatment.
4. Surgery.

He said the surgery would be the very last option as the success rate is extermely low. He also added that someone would have to in a considerably worst condition than myself before he would even think about surgery. Could the problem be just confined to the States where you have lots of surgeons all seeking work?.

Trust me,.... In England,... Orthopedic surgeons are like rocking horse s--t!.

Re: Very Depressed...WANT surgery

Ralph on 8/28/05 at 15:43 (181318)

Joe,
I'm not disputing the fact that foot surgeries are necessary to repair
birth defects or deformities, crushed or broken feet, smashed heels or any other type of catastrophic foot condition. These things need to be repaired and surgery is the only answer.

What concerns me is that Plantar Fascia releases have become a quick fix solution offered by some doctors simply because they can perform the operation. It's a fast surgical procedure but it can have long lasting consquences for the patient if something goes wrong.

Most patients know nothing about their feet and the importance of the structure that they are asking doctors to cut.

In the states we have access to far more specialists so patients have opportunities to 'shop around' to secure several different opinions. Second and third opinions don't come free, but they might save a patient from a lifetime of pain.

I don't know if your socialized health care system provides the same services or not but I think the more opinions you have, and the more knowledge you have of your condition and treatment being offered the better off you are. Patients need to take an active role in their health care, not just opt for any treatment offered or what they think will provide them a quick fix.

The problem isn't just confined to my state or to any one state. I think you'll find it U.S. wide because where ever there are doctors you will always find some as Dr. Ed pointed out performing surgeries for financial gain.

I think when people are offered P.F. surgery they immediately think they will be pain free and it's no big deal because its a quick surgery, it can be done in an office setting and heck it's only being done on their feet.

They forget that those feet must support them for the rest of their life and think nothing about the weight that they carry each and every day.

They have no clue that walking on scar tissue is a real painful problem, that nerves can be accidently cut, that infections occur or that one botched surgery can lead to another causing even more problems.

Here's the recipe for you:

Take one uninformed patient with foot pain, add in one doctor willing to perform surgery for financial gain, then stir in insurance coverage.

Mix well in a comfortable setting for about 15 minutes, throw in a pair of orthotics for support, then wait to see the results.

Questions about your surgery promptly answered on heelspurs.com.

Re: Very Depressed...WANT surgery

Joe M on 8/30/05 at 13:29 (181403)

Ralph,
The last paragraph should be advertised by our respective health Departments. I recently saw a PF surgery being performed on this site, I am totally amazed that someone would allow a so called consultant to perform such a procedure, it is nothing short of butcherary.

How can a surgeon honestly believe that without seeing the actual site where the cutting (bodging) is taking place that a high risk of mistakes can occur and quite obviously do!.

As I told you previously, I discussed this option with the surgeon who conducted my original operation, his response was,... I quote 'this type of surgery has a very low success rate and as consequence should never be conducted without all options being explored'. He also added that natural healing can take upto 18 months.

At the end of the day it is the individuals choice, and as such, people being people, bad scenario's will always be evident.

Regarding the National health system. It would take 18 months to see an orthopedic surgeon in this country and PF surgery would take you to the bottom of the waiting list, hence , at least 5 years before any surgery would be completed. No worries of anyone making a mistake in England through the National health system.

Re: Very Depressed...WANT surgery

Ralph on 8/30/05 at 15:06 (181405)

Wow, I had no idea the length of waiting time it takes to see a specialist or have a surgical procedure performed in England.

I think we can get in to see doctors here rather quickly. I've found some specialities have longer waiting times. Neurolsurgey is one of them. I'm finding that out through experience although things like having MRI's have gone very quickly. Most MRI centers seem to be open late into the evening and I know of one that is open 24/7.

Most hospitals have an MRI and we also have free stand centers. Don't know about any mobile units but it wouldn't surprise me.

Are there also waiting lists for tests like MRI's and CT scans etc? What would be the turn around time for an MRI if your doctor ordered one?

Re: Very Depressed...WANT surgery

Joe M on 8/31/05 at 14:05 (181504)

Ralph,
Don't get me wrong if you are seriously ill you will receive treatment immediately however, to qualify for that speed of care you need to have one leg hanging off and half your head missing.

I had an MRI scan on my back when I was 24, it took 12 months to actually have the scan, by which time the problem had cured it's self. What happens here is the scans are run by private companies who charge the National health for the use. What I can't believe is what happens with the scan film. Apparently they send the images to South Africa for annalysis taking upto a month to get the results.

It has been reported on the news here that we do not have sufficient medical professionals to cope with the demand. The reason they do not have enough medical staff is because the one's who have been trained here emigrate to America or Australia.

I Hope you guys over the pond appreciate our medical staff (only joking). Our doctors move to your side and we have indians and middle east doctors, half the time you can never understand exactly what they say!. But, as with any statement that is refering to human beings there are always exceptions to the rule and I am happy to say the surgeon I see is an excellent communicator.