scared to death
This is a thread posted in category: Foot Surgery . . View All Heel Pain CategoriesPosted by christyw on 8/12/04 at 22:25
Thanks
Posted by Julie on 8/13/04 at 01:32
Christy, at least get another opinion before you go in for surgery. It may be the right move for you - but then again it may not, and if it isn't entirely successful you may regret it. I hope this doesn't sound cynical, but sometimes a doctor's "last option" is all he knows - or even what he wants to do.
When I hear the words "tried everything" I always wonder whether the "everything" that has been tried were really the right thing(s) for that particular person'e particular case of PF, based on an accurate diagnosis of the causes. Were the shoes the right shoes (the wrong ones can cause a lot of trouble)? Were the orthotics properly casted and correctly made? even if they were the right things, how long were they tried for? There is at least one thing you haven't tried: ESWT.
And there is one more thing you haven't tried, and I think it may be the most important. Change your job, or at least your duties. Standing all day is one of the most frequent causes of PF. Continuing to stand all day makes PF extremely difficult to cure. If you have surgery, you will be losing the main supporting structure of your foot - standing all day may become impossible.
I am very sorry if this scares you. But you really need to do more thinking and more research before you opt for the knife. Now that you have told us that you do a standing job, I would urge you strongly to put off the surgery and seek at least one more opinion.
.
Posted by christyw on 8/13/04 at 09:48
Posted by Susan S on 8/13/04 at 10:03
It sounds like all the standing you have to do at work could be the main cause of your feet feeling so bad. With all that standing, probably all the treatments wouldn't do much good because your feet can't rest at all.
I would consider looking into retraining at a community college perhaps for a job that doesn't require standing. I have had PF for 2 years, but my ability to work has not been impacted at all because I have a sit-down job. This makes the urgency less for major measures such as surgery. There are a lot of interesting careers out there and you're young.
The best of luck to you,
Susan
Posted by john h on 8/13/04 at 10:51
Posted by Marty from SLC on 8/13/04 at 13:07
As far as surgery goes I have had it over 1.5 years ago and still suffering from it. Would I do it again? In my case yes, I was at the bottom of the pit in my opinion. Even though it's taking so long to recover I don't believe I have any other roads to take. It's kind of like those who say are conjoined twins, do they live their lives they way they are or undergo surgery and risk it all - death to some. I know that's extreme but it's the best I can do. LOL
Good Luck
Marty
Posted by april l on 8/13/04 at 14:58
Posted by Ed Davis, DPM on 8/13/04 at 14:58
It has been a few months since I have done a full release since the success rate with ESWT has been so high. Those who have not had complete success with ESWT have, at least, brought their level of discomfort down to the point that they will not consider surgery.
By the way, we, a long time ago discussed the possibility of surgically lengthening the fascia instead of cutting it and I stated that that was not possible. I have been thinking about this for a long time and am reconsidering that it MAY be possible. The residents I am teaching have some cadavers they are working on and I am going to test a novel approach that may allow the fascia to lengthen. If this works, yet another alternative may exist....stay tuned...
Keep in mind that the fascia is a strut that supports the foot so even lengthening it, while sounding like a good idea, has the potential to have complications in that we are shifting workload from fascia to other structures so adaptation time is needed. It boggles my mind to see that the are those getting EPFs but no casts or supportive devices to allow the foot to adapt to the loss of the fascia. EPF's are a rare procedure in the Northwest as many of us feel it is not superior (possibly inferior) to classical open or minimal incision techniques. It may carry a higher reimbursement rate.....let me say no more.... that is a whole other story.
Ed
Ed
Posted by kjj on 8/13/04 at 15:14
Posted by John King on 8/14/04 at 14:52
Posted by Pauline on 8/14/04 at 20:43
How do you stretch or lengthen a stiffen cadaver plantar fascia and compare it to that of living tissue?
Posted by JCleve on 8/14/04 at 22:29
Posted by Ed Davis, DPM on 8/21/04 at 14:21
There are two types of cadavers, those that are preserved with formaldehyde at room temperature and the tissues are stiffened and "fresh" cadavers that are kept frozen and only thawed for doing procedures on. We use the latter. The fresh ones have tissue that is not too different than living people.
Keep in mind that the classical methods for lengthening a tendon could be performed on either type of cadaver. The fascia is not a tendon but rather an aponeurosis that acts like a strut. Unlike a tendon that glides freely, the plantar fascia adheres to muscle and that is the dilemna with "classical" techniques applied to a lengthening. That is why I have to come up with a novel and new approach. I have not "solved" the problem yet but here is a clue to what I am thinking. I envision not touching the fascia that is adherent to the underlying muscle but basically lenghtening a "layer" of it that has been "teased" apart from the adherent portion and only lengthening that portion. Stay tuned for more details as I work on the solution. Invariably, even this "solution' may be a bit too traumatic and not practical so coming up with a minimally traumatic approach is part of the solution...
Ed
Posted by Lisa I on 8/24/04 at 15:53
Posted by christyw on 8/24/04 at 17:02
I have had the surgery. A week ago today. Everything seems fine so far and the doctor said everything went well. You can read some of the other things I posted on here if you want to know how I am doing. What are the symptoms of RSD and did you know right away that you had it? Tell me about your surgery and how did you feel after you had it done. Where you pain free at all. I want to know all about it if you don't mind. I go in on Sept. 8th to have my right foot done. After surgery were you in a cast? I would like to know if every doctor does the same thing. I believe that I have a really good doctor. He was my second opinion and he has really tried to help me compared with my first doctor. I have suffered with PF for 2 years and everytime I had to miss work because I couldn't stand my first doctor would not even write me an excuse. It was a different story with my second doctor. He is very understanding. I am very pleased with him and for now everything is good with my foot. I know the main thing is going to be when I get out of the cast and walking boot and go back to work is when I will see the results of weather it worked or not. Thanks for the advice. Please let me know anything else that you feel is important.
Christy
Posted by Pauline on 8/24/04 at 20:08
My question is based on one of the sentences you wrote " I know the main thing is going to be when I get out of the cast and walking boot and go back to work is when I will see the results of weather it worked or not".
After reading Lisa's account of her foot surgery and then your sentence it really makes me wonder why you would not wait before having your second surgery until as you say "see" whether it worked or not.
I hope and pray that the decision you're making work out. This site has seen enough failed surgeries for a life time and it's unfortunate for those that are only seeking pain relief to have outcomes similar to Lisa's.
Wishing you the very best outcome. I think everyone here shares my wish for you. Good luck with # two.
Posted by christyw on 8/24/04 at 23:11
Posted by Julie on 8/25/04 at 02:27
Christy, please listen to what Pauline and others have been saying to you, and defer your second surgery until you are really sure that the first one has been successful. You will not know that for at least six months (whatever your doctor says) and perhaps a year. "Trying something and hoping for the best" is not a very good option, because you could be left a good deal worse off that you are now. You know the saying "jumping out of the frying pan into the fire". It applies to foot surgery. Just the other day there was a post by Rose, who had surgery a year ago and has now developed a new problem and new pain (probably lateral column syndrome) resulting from the surgery. Cutting the plantar fascia removes the foot's main supporting structure, and even so-called "successful" surgery has resulted in additional problems down the line for many. Has your doctor mentioned this possibility, and taken steps to avoid it? Has he casted you or is he going to cast you for orthotics to replace the lost support?
Foot surgery is unique: our feet are the only part of our body that we walk on, so they are difficult to heal. No other body part takes that kind of punishment.
Scared to death can sometimes be a useful state of mind: it can keep you from jumping into the fire, from jumping into surgery.
I hav rarely said anything to lead anyone to question the competence of his or her treating doctor, but I'm going to now. I have been thinking ever since your first post that your doctor's airy confidence about EPF surgery is not confidence-inspiring. It is worrying. The doctors here have made it very clear over the four years I have been reading these boards that they do not think EPF is a good option. Please, please be careful, and at least get another opinion.
If you do decide to take our advice and wait, I suggest that when you go back to work you may be able to relieve the pain in the foot you haven't had surgery on by taping. In the heel pain book part 2 there are instructions for a very simple, effective technique. I found it extremely helpful when I had PF. Taping works because it takes over the job of supporting the foot which the injured plantar fascia cannot do. I think you would find it helpful to investigate it and try it.
.
Posted by Pauline on 8/25/04 at 08:50
I think at this point all that can be said has been said. If I had one wish I'd have Christy go back and follow Tammie's life since having her P.F. surgery.
What started as a simple "snip and go" P.F. release turned her life into a living hell. Here is just one of her respones to a fellow poster. If you recall Tammie went from having P.F. surgery to TTS surgery to ending up with R.S.D. her history is here for all to read and as she says herself "learn from it".
Re: Surgery next? View Thread
Posted by Tammie on 7/28/03 at 23:29
Rick Please Think about that second surgery! It didnt work the first time You said although if I read right you said it was this last May? If so that is not very long for you healing as it can take up to 6 months or a yr at that not a good reason to jump into another surgery! I am telling you this because if you search back on my name you will see that I to had the surgery for the heel spur and the pf release and no not work to well so they went back in thinking it was a nerve compressed and guess what? I now have RSD and most of my Dr.s who have DX me have told me they feel I had it before my second surgery . Not being able to examin me tho they could not tell me positivly but there feelings on what I had described told them enough that they felt they should have not done the surgery and they should have done some testing such as perhaps a MRI a Nerve testing More PT even But not more surgery .
It is not my decision to make for you but If I could change your mind slightly I would tell you to run like the wind and find some other Dr.s and search for the ones who tell you it has not been that long to heal! Rick a few months may make a big difference in the rest of your life ,Really get some other dr.s thoughts take the time it is really worth it learn from my mistakes. I know have a spinal stimulaator in dealing with RSD this started out with me having a heel spur and pf surgery DR told me no troubles be back in shoes in 10 days whatever and it went into another surgery and then my nightmare began leading into a fianl dx of RSD so please dont rush the surgery , take the time find other dr.s You need to question WHY it didnt work anyways dont you? Good Luck to what ever you do!
Message Number 125346
Posted by Julie on 8/25/04 at 10:56
Yes, Pauline - it has all been said. And I believe, as I know you do, in supporting people in the decisions they've made once they've made them. But. It breaks my heart when I see another Tammie situation taking shape, so I keep repeating myself. I hope Christy will research Tammie's story. And I hope she will be luckier than Tammie, and luckier than others we've seen come and go here.
.
Posted by april l on 8/25/04 at 12:24
Posted by christyw on 8/25/04 at 18:47
Posted by Tammie on 9/04/04 at 01:29
I thought I made the right choices also And maybe I did , for the first surgery but if to do over again , I swear I would not let a sharp object near my foot again at least very doubtful and NEVERNEVER tarsal tunnel Sorry but I see a pain management and each time there are so many of us there and seems like so many are related to things gone wrong in that type of surgery or after that . There is so many things that COULD cause RSD of course but then there are down right signs that good Dr.s who know what they are looking for should know what they are and when there is more pain that is considered NORMAL or wayyyy out of proportion to the injury or surgury it means stopppp no more surgury find out whyyyyy first. Before your life turns into a brutal nightmare with a sad ending.
I was like you worried to get back to work, loved my job went back with pain still there worked a few months if , and now I will most likly never work again in my life. If I can keep walking will be the challenge of my time now. I have spreadage, I have had a spinal stimulator put in 5 or so revision surguries on it, several meds and my currant ones I am unable to drive do much of anything due to pain my toes are like curling under now and loosing muscle in leg and foot looks verry odd. No dear if it were me I would stop now and see how this goes take that time to heal you have to have surgery in feb right? Well give yourself time to heal the see maybe things will be better then? Can take a year to heal and give it that much time dont jump before the time. If your foot is super sensitive massage it if you feel the pain is much more then reasonable and your dr. seems worried aske him about RSD or CRPS there is always no shame into another Dr.s thoughts also always better safe then sorry later. No rush there is all the time as if it would turn out like mine you wouldnt be worrying about returning to any job a year or so later, as you wouldnt be able to . Getting SSD is not fun either it is degrading and very difficult when you look normal one minute and then the next in pain or symptoms of the rsd it is hard for most people to see. I have been put threw a small heck of my own dealing with people and lawyers and getting ready to see a judge and prove to him I cant work.
You live a life on narcotics and several other meds to go along with other symptoms of RSD and then the emotional aspects as well you end up with a couple of the antidepressants.I am only telling you this gruesome details not to get piety or anything like this it is to show you or anyone just what it could mean if YOU decide to be cut and it is the wrong DR or if the DR. really makes a mistake or you push to do things before they really have tried everything possible. Even consider getting some help with pain such as seeing a pain management Dr. while being treated for foot troubles if it is that painful and lack of sleep and such and you have the DR> who does not think you need anything you are a baby kinda DR. PLEASE I do ask you all to really think before the surgeries. I am NOT against all surgery or surgeons I think YOU have to research and I really mean research the Dr.s and the procedures they wish to do and the good and bad and ask what they shall do if it does not work and all questions you can think of first!
That was something I learned later much later I ran into some ladies that had seen same Dr. as I had and guess what? They had foot problems also he liked to jump into surgery and tell you he did everything he could , yada yada. The wife of his also a Dr. was supposed to be the best she did the non surgical methods right after I left there and she was known to have a attitude but latter was found she grew tired of fixing her husbands botched foot jobs. To bad couldnt have got this info 2 yrs ago. So asking around does help! Pain managements in area were helpful in this case I would have not thought of that.Please dont be offended I only stopped to give my story a update and to allow someone to hopefully not be in my place it is very lonely but I dont want to have any more company lol You need to get healthy and enjoy them feet and please tell all those you know take care you only get one set! My family says I would be good for a comercial as I tell everyone and watch everynes shoes and how they walk .
Good luck if you ned anything post and use my name I will get it !
Posted by Tammie on 9/04/04 at 01:51
Posted by Julie on 9/04/04 at 02:01
It's good to see you here. I am so glad that you wrote your post, and I hope that Christy reads it and thinks about it.
Regarding your second post to April, no-one who knows you and has followed your story from the beginning would think anything but good of you. People do need to know the "whole story" and there is a great deal to it. Your side of it is extremely important. People need to know how important it is to do their research, and avoid surgery if at all possible.
You have learned so much over these years, from your experience. I know you wish you hadn't had to learn it all so painfully, that you'd rather be back at the job you loved so much. But through sharing it here, you have helped others. You can be proud of that.
Don't be such a stranger - do look in now and then. We're glad to see you.
All the best,
Julie
Posted by Pauline on 9/04/04 at 10:29
Something you mentioned in your post caught my eye and I wonder if you'd expand or comment on it. Do you have any idea how many patients at your pain clinic developed their problem following a type of foot surgery or several foot surgeries? I think this would be an interesting fact to find out. Maybe your doctor could even give you a sense of the number of cases that started there.
Posted by Pauline on 9/04/04 at 10:35
I think Tammie's timing to post was perfect and maybe it was meant especially for Christy who's second surgery is comming up pretty fast. I was wondering if she had changed her mind yet. Hopefully after reading Tammie's post she will really reconsider things. We know all too well the nightmare that entered Tammie's life after a so call simple surgery.
Posted by april l on 9/04/04 at 10:40
Posted by april l on 9/04/04 at 10:52
I do think good of Tammie and know her story. And I agree that people need to know the whole story regarding these surgeries. That's exactly why I posted. It seems most people here are against surgery. People are suffering like I did and surgery can help. True that the reality is that it doesn't always help and can make things worse. It just seemed to me that everyone was telling christy not to do it, not just informing her but telling advising her to cancel.
Posted by Julie on 9/04/04 at 11:11
April
When I post to anyone, I always try to talk to that particular person, taking into account everything I know about the situation - and the person - from what has been said. There was little doubt in my mind that Christy did not know what she was letting herself in for in going for surgery in the first place, let alone a second surgery so soon after the first, particularly EPF surgery, which does not have a very good success rate, and particularly with a doctor who - to me - sounded cavalier in his airy confidence. So the most important thing seemed to make the pitfalls very clear, and advise her to step back and think, and not rush into anything.
If I were talking to someone who appeared to have a clearer idea of what is involved, I would speak differently.
Once the damage is done, it is done - witness Tammie, the start of whose journey was too much like Christy's for comfort. Some of us "advised" her over and over again to be careful and she has several times said she regrets not having listened. She was in a hurry to be painfree and get back to work - just like Christy. And she had the same sort of doctor.
It's not a question of "right or wrong" but of the individual and his or her circumstances - and knowledge.
I am glad your surgery has been successful and I wish you continued improvement. Do take on board what the doctors and Richard have said: once the main supporting structure of the foot has been removed or weakened, additional support (i.e. orthoses) is usually essential.
.
Posted by april l on 9/04/04 at 11:29
What exactly is the real success rate of EPF? My doctor (second one) said the success rate is 90%. I've heard people on here say that that is just not true. I'm wondering what the truth is.
Posted by Julie on 9/04/04 at 11:42
April
Glad you see my point. Regarding the success rate of EPF, if you want exact figures you should ask Dr Ed or Dr Z about this - try on the Ask the Doctor board.
.
Posted by Pauline on 9/04/04 at 11:45
An added note. If you can't wear the orthotics what do you turn to next.
The structure has already been cut.
Tammie's story is probably the worse I've read about on this site. She had the "snowballing" surgeries that we warn about. Like many she couldn't afford to put her life on hold, lose her job, and not care for her family, but when all was said and done those very things that were important and of concern to her came to pass along with her paying the very high price of being in constant and continual pain.
I agree with Julie because I too felt that Cindy's doctor was a little tooooo eager to get her surgeries done and over with. My first thought why all the rush, when he knows the possibility of Tammie's results are a reality.
Tis better to know the worse, expect the best and not rush into any surgery unless it's a life threatening situation. I'd much rather see Cindy have one foot totally healed before she has the other done, but that's her choice not ours anymore.
Posted by Julie on 9/04/04 at 11:54
Yes, that's true. I have been lucky with orthotics, but others haven't. It's too bad that we can't always have the best-case scenario: a skilled podiatrist or cped who knows how to cast, and prescribe, and construct orthotics that are absolutely right for the individual. But it seems we don't.
Yes, Tammie's story is the worst, and the saddest. I always have her in mind when people in Christy's situation post. It worries me terribly. Those of us who have been around for several years have built up a multilayered picture of the "feet scene" which people new to the boards don't have the advantage of. I too hope Christy waits, does her research, and makes a good decision.
But you know, the thing that worried me more than anything else in this case is that the doctor did NOT seem to know about the possibility of a bad result. 'Snip and go", as you've often put it: that's how he looked at it. And then snip and go again, in a couple of weeks. And then all is well, back to weight-bearing and normal activities, fully cured forever.
I wish!
.
Posted by april l on 9/04/04 at 12:56
Posted by Julie on 9/04/04 at 18:35
April: the doctors here, and Richard, have all said on various occasions that support is needed after surgery to replace the support that has been lost when the fascia has been cut. One of the problems that can result further down the line is lateral column syndrome, which several posters have developed.
Perhaps I have misunderstood, or perhaps this is not the case with the particular type of surgery you have had: why don't you ask them? I am not a doctor, as you know: only trying to pass on information that I have gathered from reading the doctors' advice to others.
.
Posted by christyw on 9/06/04 at 15:28
I don't think I have seen your post on here about your surgery. can you tell me about it? How long did it take before you knew that it wasn't successful? So far everything has been good for me. I don't have hardly any pain.
Thanks alot
Christy
Posted by Pat on 9/11/04 at 20:23
Posted by Crystal on 9/12/04 at 10:09
