Monthly Progress Report for T. Hurst

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This record is for T. Hurst treated by a Podiatrist. The surgery was on 07-26-2000.
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First Entry: Date: 07/29/2000 . . . Pain Level: . . . Activity Level: . . . Satisfaction with surgery:

Date: 07/29/2000 . . . Pain Level: . . . Activity Level: . . . Satisfaction with surgery:
I am 3 days post-op from EPF on both feet. I walked out of the hospital the day of the surgery. The pain is minimal. I have boots that go up to my knees that I wear all the time, even when I sleep. I limit my walking to only that which is necessary and comfortable - bathroom, kitchen, to the store to get ice, etc. I went to work yesterday and propped my feet up all day - not bad. I also drove yesterday. Since the boot is inflexible, I took it off and put a loose shoe over my bandaged right foot and drove. No pain whatsoever. Then I immediately replaced the boot before bearing weight. At this early stage, everything is going as good as can be expected. One other note - even though the insertion path is tender, I know longer feel the familiar pulling of the fascia - nice!

Date: 08/05/2000 . . . Pain Level: . . . Activity Level: . . . Satisfaction with surgery:
Day 10 post-op report: Stitches came out yesterday and boots are off! I'm cruising around in my running shoes with custom inserts. I walk pretty slowly, as the incision path is still a little tender. My only fear at this point is my right foot is doing significantly better than my left. I feel a little pulling on the outside of my left foot (where the fascia is still connected) - something I didn't feel before surgery. But from what I've read on this site & talking to my doc, this is a common thing and is easily corrected by adjusting the orthodic. So I'm not overly worried. Before surgery, I had what is known as "Windlass effect" - where pulling up on the big toe would stretch the fascia - mine actually protruded quite a bit from my foot! Anyhow, now that doesn't happen - there is no response. Pretty neat, I think. So far, so good. No regrets. Will check back in 2 weeks.

Date: 08/14/2000 . . . Pain Level: . . . Activity Level: . . . Satisfaction with surgery:
It's Day 19 post-op both feet epf. At Day 16 I went back to pod to inquire about the pulling on the outside of my left foot. It was preventing me from taking a full stride and made me limp and was painful. He added a cuboid pad to correct the pulling. It helped noticeably, but there was still some pulling. He said best case scenario was it would work, worse case the surgery would have to be done again to release the fascia entirely (scary!). I was pretty stressed. Today, I made the dreaded trip to the shoe store. I got a pair of stiff-soled Rockport walking shoes. NO more pulling! I also discovered New Balance shoes with ROLLBARS, which provide this same stiffness in a running shoe. Yeah! I can now walk normally with a full stride and the pain is already going away. The key is not to allow your foot too much flexibility. This is good advice pre or post surgery. Next appt. is on Day 21. I think I'm out of the woods. No regrets yet.

Date: 08/25/2000 . . . Pain Level: 4 . . . Activity Level: 1 . . . Satisfaction with surgery: 9
Day 30 post-op: Had my last post-op pod appt today. The cuboid pad placed on my orthodic 10 days ago has worked. It has stopped the pulling on the remaining portion of fascia on my left foot. Yeah! I still have normal post-surgery aches, but absolutely no pf pain. Basically, my feet tire quickly. I don't stand on my feet for more than two hours tops at a time. But I'm back to all my normal activities besides exercise. I think I will be able to exercise on my feet in another month or two. So I have finally deemed my surgery a success!

Date: 09/03/2000 . . . Pain Level: 3 . . . Activity Level: 3 . . . Satisfaction with surgery: 9
Almost 6 week post-op update: My healing has increased significantly since the cuboid pad was added to my orthodic. Big change between weeks 4 and 5...major progress. Yesterday I shopped the malls for 8 hours of continual walking with very little pain (some achiness...but even my "normal" friends had tired feet). I'm still wearing only steel-shanked shoes with laces and my orthodics and I'm sure I will for life. I don't walk barefoot and wear high-arched slippers in the shower, just to prevent any lack of support. Tried running a lap at the gym last week. It didn't hurt to do it, just felt awkward. But I could feel pain the next day, so I know it is too early to run. I am back to stationary biking and lifting. So things are going great.

Date: 10/01/2000 . . . Pain Level: 3 . . . Activity Level: 3 . . . Satisfaction with surgery: 9
Two month post-op report: my progress has slowed, which I think is normal. My everyday walking continues to be pretty much pain-free. I have added some (about 5 minutes) of elliptical precor machine to my routine to start working my arch again. I also have started using the pft, with the help/advice of Mike Wilmont (thanks!). Still taking ibuprofen (backed down to 1800 mg/day) plus Vitamin C (backed down to 3000 mg/day). I am no where near ready to run. Last week I hiked about 1.5 miles down a rocky creek (for work) - it didn't hurt to do it, but I could feel some tenderness the next day. Uneven sufaces still scare me. I'm still happy with my progress, no regrets....hey, it's only been 2 months. As the docs have told me...the whole dynamic of my foot has been altered - it will take time to adjust!

Date: 11/02/2000 . . . Pain Level: 3 . . . Activity Level: 3 . . . Satisfaction with surgery: 8
Three month post-op report: I had a post-op visit this week, my first since the one month mark. I thought things were on schedule, but my new pod feels I should be doing much more. I still cannot run, which he sees as unusual. I've had lateral destabilization problems on the left from the beginning. My first pod mentioned the possibility of, in the future, going back in and releasing the "rest" of the fascia. This new pod says my problems are because the "entire" fascia was released. Dr. Z. says a full release, even if that is the goal (which no one does anymore) is virtually impossible. I have read journal articles re: cadaver research that support Dr. Z's statement. I think that TOO MUCH fascia was released. Whatever is going on, my healing time has increased and now I am not sure I will ever get back to my normal activities. I'm not giving up hope, but my expectations have changed. I'm still better off than before surgery (lots), so I can't regret it. Well, the new pod put me on prednisone dose pack (which I've had before...superwoman for a week, then back to normal), followed by 3 weeks of pt. I'll check back in after my pt is complete.

Date: 11/21/2000 . . . Pain Level: 3 . . . Activity Level: 3 . . . Satisfaction with surgery: 8
3.5 month post op report: Just got through with 3 weeks of physical therapy (2X/week) including ultrasound with steriod creme plus lots of stretching and strengthening - especially between appointments. Things are better - I feel improvement for the first time in over a month. I still have lateral pain, esp. on left, but my feet feel more agile and a little tougher. PT says my flexibility increased already. Went back to doc today & he seems pleased. Wants me to go 1 week without my orthodics to see the effect. He thinks the cuboid pad I had added to my left orthodic may be unnecessary. If going without orthodics doesn't work, he is going to do some pressure testing and make me a new pair of orthodics. So, we'll see. I would suggest anyone who has heel surgery begin PT as soon as possible. It definitely helps.

Date: 11/29/2000 . . . Pain Level: 2 . . . Activity Level: 3 . . . Satisfaction with surgery: 9
4 month post-op update: As my pod suggested, I've weaned myself off of my custom orthodics and have now gone 1 week without them. I questioned this experiment, but WOW, my feet feel so much better! It is the biggest jump in healing I have seen so far. So the orthodics, which were casted pre-surgery, were evidently doing harm. My feet are much less tender and even 50% of my lateral pain is gone. I am excited and feel like I may run someday in the near future! Of course, I continue to stretch and strengthen (at home, no pt now)every day. Hope my healing continues in this direction.

Date: 12/17/2000 . . . Pain Level: 2 . . . Activity Level: 3 . . . Satisfaction with surgery: 9
4.5 mo post-op report: After success going without any orthodics for a couple weeks, my doc said I did need some support. He said my hard custom orthodics were too much (overcorrective) and were doing harm. He had me get a pair of Spenco, over-the-counter, 3/4 length hard orthodics (hard on bottom, cushy on top). I've worn them for about a week and they feel good - best my feet have felt yet. Best news - they were only $25! He said if I liked them, he could order me a thinner version for dress shoes for $60. Hard to believe I've bought $600 worth of orthodics to find the $25 pair works best. My feet are continuing to noticeably improve. I even "trotted" to the mailbox today (it's 10 degrees out!) with no pain during or after. I'm up to 10 minutes on the treadmill and I will now start to increase my pace to a near run (gradually). All is well!

Date: 01/09/2001 . . . Pain Level: 1 . . . Activity Level: 4 . . . Satisfaction with surgery: 9
5.5 mo post-op report: I continue to wear my prefab, 3/4 length, hard Spenco inserts. The doc has ordered me another prefab, extremely thin insert made out of pliable metal to wear with dress shoes. I might actually be able to wear all those shoes in my closet again one day! Since the new inserts, I have progressed from not being able to do even 5 min. on the treadmill without next-day aches, to nearly a jog for 10 minutes. I should be jogging by this time next month, albeit slowly and not for long. Things haven't looked better! I just never thought it would take this long to heal...docs should prepare patients for a lengthy recovery that is well worth the time.

Date: 02/04/2001 . . . Pain Level: 1 . . . Activity Level: 5 . . . Satisfaction with surgery: 9
6-month post-op report: I AM JOGGING NOW!!!!!!!!!!! The docs told me it would take 6 weeks to get to this point, but it has taken 6 months. I have gradually, since the 4.5 month mark, increased to a jog on the treadmill. At 4.5 months, I was not able to do a full 10-minutes & spent a few weeks gradually working up to that duration without increasing my pace. Once I could do 10 min, I increased my pace a little each day, progressing toward a slow jog. Now, I put in my 10-min. as a warm-up, and jog after that. I am increasing my jog by 30-second increments each day, and am up to 1.5 minutes. Thus, I have jogged for 3 days in a row now with NO pain. Yeah!!! I am wearing my New Balance with the steel-shank, along with my prefab 3/4 hard inserts, described in my last entry. May I add that these inserts go in all my dress shoes & I can actually be somewhat fashionable again! I am happy! I spend at least 15 min. in the morning and 15 min. before and after a workout doing the stretching excercises that I learned through physical therapy. It has been worth the 6 months. I am prepared to spend the next 6 months working on my feet & working toward a normal workout (eg. playing soccer). Anyone who has this done should be prepared for a full year of recovery, in my opinion.

Date: 04/21/2001 . . . Pain Level: 1 . . . Activity Level: 8 . . . Satisfaction with surgery: 9
9 month post-op report: I AM PLAYING SOCCER AGAIN!!! Since the 6 month mark I gradually increasing me jogging, incorporating non-weight bearing cross-training exercises and making sure not to overdo it (not jogging thru pain or tightness or for 2 consecutive days). I moved and met with my new pod (#4!!) and he advised against using a treadmill since it does not result in a natural foot motion. So I switched to grass/some pavement and was able to quickly increase my distance. I now run for 20-25 minutes about 3 times a week. And I can play 90 minutes of soccer! I did have some tightness after the soccer, so now I'm on Vioxx to ease the transition back into soccer. It is working great and I hardly notice my feet anymore. Still stretching (for life!), icing after workouts, Vioxx, and wearing my inserts. Couldn't be happier. This time last year I crawled off a soccer field. Now I'm back, thanks to the help and advice of so many people.

Date: 08/18/2001 . . . Pain Level: 1 . . . Activity Level: 9 . . . Satisfaction with surgery: 10
1 year post-op report: I'm 95% back to normal, which is a very high activity level. I'm playing and coaching soccer almost every day of the week. My only crutch at this point is Vioxx, which I have taken for several months now. I've tried weaning myself off of it, but I can't at this point because some tenderness and inflamation inevitably returns. But I think I'll be ready to get off of it shortly. I don't even notice my feet anymore - life is good!!!

Date: 01/05/2002 . . . Pain Level: 2 . . . Activity Level: 1 . . . Satisfaction with surgery: 10
1.5 year post-op report: I've been sidetracked...I was diagnosed 2 months ago with ulcerative colitis, a chronic disease of the colon. My gastroenterologist immediately removed my crutch and took me off Vioxx (I doubt I will ever be allowed to take it again). I'm on prednisone (a cortisteroid) for my colitis - which has tons of side effects (it's a toss up which is worse - PF or colitis!). Well, my feet immediately became somewhat tender, not bad, but noticable. I'm not allowed to exercise anymore, but I am guessing I am going to have some uncomfortableness to deal with once I get back to it. Without Vioxx, I doubt I will be able to get back where I was, but hopefully close. So maybe 85%-90% instead of my boastful 95%! I will always wonder if Vioxx played a role in my colitis, although the docs will not speculate.

Date: 04/02/2002 . . . Pain Level: 2 . . . Activity Level: 7 . . . Satisfaction with surgery: 10
1 year 8 months post-op report: I now have my colitis under control & am off of steroids. I will never be able to take NSAIDs for my PF again because it can cause a relapse in my colitis. I'm now limited to Tylenol for pain! Fortunately, I've eased back into play soccer once a week (whole games) and racquetball 1-3 times per week. There is noticeable tenderness the day after soccer (not r-ball), but it goes away quickly. I've concluded I won't be 100% again, but am very, very happy with my current activity level of about 85-90% of that before I got PF. I expect things to remain steady from here on out.

Date: 05/05/2005 . . . Pain Level: 2 . . . Activity Level: 7 . . . Satisfaction with surgery: 10
4 year 10 month post-op report: No change - things are still great.

Date: 12/08/2005 . . . Pain Level: 2 . . . Activity Level: 7 . . . Satisfaction with surgery: 10
I HAVE HAD PLANTAR FASCIITIS FOR SEVERAL YEARS AND HAVE HAD CORTISONE INJECTIONS AND THERAPY AND TAPING AND ESWT. I A WONDERING WHAT EVERYONE THAT HAS HAD EITHER OPEN SURGERY ON THE FASCIA OR THE ENDOSCOPIC PROCEDURE IS DOING AFTER MONTHS AND NOT JUST DAYS LATER.

MY PODIATRIST, WHICH IS THE FOURTH DOCTOR I WENT TO SUGGESTED THE ENDOSCOPIC PROCEDURE. I AM APPREHENSIVE DUE TO HEARING ABOUT SIDE EFFECTS OF PAIN AND DISABILITY AND POSSIBLE NERVE DAMAGE.

HOPING TO HEAR FROM SOMEONE ON THEIR PROGRESS. I AM A MECHANIC AND WHEN I WORK (ON DISABILITY NOW) AM ON MY FEET FOR LONG PERIODS OF TIME AND LIFT HEAVY EQUIPMENT. THANKS J J