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Old 12-17-2004, 03:04 PM   #1
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7 months later... Severe pain, not improving, badly depressed. Help please

It is now 6 months since I had my ankle surgery. There is a name for the procedure but I can't remember it. They took my tendon, sliced it in half lengthwise, and brought it back and around through a hole that they drilled through my ankle bone. I was NWB for 6 weeks, then gradually went to full weight.

I have been to pt. I have done the excercises. I have even had a cortisone shot since the surgery.

I can barely move my foot from side to side. I have had a good return of my up and down motion and that is almost the same as my "good" foot.

3 weeks ago I had to have a meniscectomy on my left knee. It deteriorated during the months of limping off my leg with the ankle injury and onto it so now I am rehabbing that as well.

I keep getting an excruciating, stabbing pain in my foot just in front of where my ankle bends forward, on the top of my foot. I will be walking along and suddenly it feels like someone just jammed a screwdriver into my foot. The pain feels like it is in the bones, but nothing shows on X-ray.

Also... The scar is horrific, hurts and is all raised and red. It shouldn't be like that 6 months after surgery.

They now have made inserts for my shoes, but they are not helping at all. I still have the same arch and top of foot pain.

When I originally went to see the doctor this is the pain I was concerned with. My ankle hadn't really given me problems except I sprained it easily and it would "fold" over easily. I could deal with it though. They thought the ankle problem was causing the foot problem because my foot was compensating for the weak ankle. Well my foot is just as bad as it was, actually it is worse!

I am really sorry that this is soooooo long, but I can't take it anymore. I haven't worked in 7 months. I don't know how long my disability insurance will continue to cover me, and there is no possible way I can work like this. I am getting severly depressed, to the point where I am considering seeing someone about that because I am crying almost everyday. I don't know if it's the pain, or if it's the depression from this ordeal and being in pain and on pain killers and stuck in my house all the time.

I'll shut up now. I just have to vent this. I am really scared about what is going on.

Last edited by Mpls21; 12-17-2004 at 03:05 PM.

 
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Old 12-17-2004, 06:26 PM   #2
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

I had the Chrisman-Snook done, which harvests part of the peroneus brevis tendon and drills holes into the talus and fibula to reconstruct the ligaments. I still have pain from the reconstruction, but mostly with movement trying to invert and evert the foot (roll in/roll out). I read before the surgery that sometimes they can overtighten the ankle. The pinching/stabbing sensation sounds like impingement, probably scar tissue or at least some kind of soft tissue. I had my surgery back in Feb and my incision is red, raised and pretty gross looking, but I got an infection and had to have it reopened in May, 6 months ago. Have you tried the gels and creams to remove it.. And if the appearance bothers you plastic surgeons can also re-stitch it nicer, I am considering getting mine done. On the other side have you tried seeing another surgeon? I know they are few, I have traveled to find good ones, but may be an option.. Good luck!

 
Old 12-18-2004, 12:31 PM   #3
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

Mpls - that sucks.

I didn't have the Christman-Snook - I had the less invasive Brostrom procedure. I am still in a cast - so I don't know totally how it is going - but I also worry about long term pain. While I did have the surgery due to instability and looseness, I also had quite a bit of pain. My doctor couldn't really explain what was causing the pain but said that sometimes instability causes pain and hopefully the surgery will fix it. We'll see (I also had arthroscopic surgery a few months prior that helped some of the pain but didn't fix all of it). I think ankles and feet are tricky and have a lot of parts and once something gets out of whack it is difficult to totally fix it.

I would definitely recommend you get a second opinion. I saw three orthopedic surgeons and found that it was worthwhile to get different points of view and they don't really mind. Try to find an OS that specialized in ankles and feet.

Regarding your depression due to your injury, you may want to read "Full Castastrophy Living" by Jon Kabat-Zinn.

Good Luck.

 
Old 12-18-2004, 07:14 PM   #4
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

Thank you for the responses and the encouragement. I am getting some names for second opinions and I talked to my doctor today. (He called on a Saturday. Blew my mind.)

He's going to take more x-rays on Monday and see what else he can do, look at, etc. I am trying to keep my spirits up and trying to remember that there are others who are far worse off than I am. I just have to try to stay out of the pity pot.

It has been very hard, and I am very frustrated. I can tolerate a lot of what is going on, but am really really worried that the surgery was unneccesary and the same problem that I originally went in for is still there and I am feeling it again because the nerves are coming back to life after the surgery.

I hope to know more on Monday.

 
Old 12-18-2004, 08:26 PM   #5
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

It is definitely super hard. I know I don't have it as bad as other people, but it sure as heck seems like it sometimes. I had four surgeries to fix my instability, the fourth one finally worked (osteotomy and chrisman snook) but I got a bone infection. Bought myself two more surgeries cuz of that and a PICC line w/IV antibiotics for 6 weeks. Now have to have surgery to cut a nerve etc. I have seen tons of doctors and all this from an ankle sprain 3 1/2 years ago. Where do you live? I may know a specialist there. :P Good luck!

 
Old 12-18-2004, 09:12 PM   #6
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

Wow Stephanie. What do you do to try and stay positive?

I'm in Minneapolis by the way.

 
Old 12-19-2004, 05:04 AM   #7
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

Mpls21,

I posted a message a couple of months ago to you, was wondering how you were making out. I hope they get this repaired for you. This is not a fun road by any means.

It almost sounds like we are having some similar problems, but my orthpod is refusing to operate, he says surgery will definetely make matters worse, after hearing your story (and others) I am thinking he may be right. I'm waiting for my 3rd opinion, we are not giving up totally here. It's gonna be my 2 year anniversary with my injury January 14th. They are also looking at nerve damage and I am waiting for a neorologist to perform an EMG.

Pain and getting others to understand it has been my biggest issue. I've had to give up a career I absolutely loved, not to mention the sports that are, at the moment, off my list. Yeah, it is depressing, but don't let it win. Stay strong! I've managed to stay of the hard drugs, can't afford to be a basket case throughout this ordeal. Dr's have tried to get me to stay on Neorontin etc, but the side affects scare the hell outta me. When the pain gets unbearable I take Advil Migraine, they seem to help a lot.

Hang in there, hopefully sometime soon they are gonna figure this out!

 
Old 12-19-2004, 07:03 AM   #8
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

Mlps, theres supposed to be good ankle surgeons at Mayo. Just a suggestion. I really don't know how I stay positive. I definitely have my down points, like everyone. I hvae faith that all this will end I guess. Or if it doesn't, its not in my control. Believe me, it took me a long time to get at ease like I am now. I also have a big support group and family to keep me going. Faith is key. I hope everything turns out alright. I know its got to be frustrating, because sometimes I don't know why I do all this (my 5th surgery this year will be the 28th). But in the end its because I am not happy with how I am and can't run or not be in pain... Hope you can keep your spirits up. If you need anything yell... or post.

 
Old 12-19-2004, 05:27 PM   #9
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

Wow... I'm really sorry to hear about your bad luck! It sounds like there is definitely some sort of complication going on there. I had the Evans procedure (they split the peroneus brevis and thread it through the fibula only) in the middle of last March. Thankfully I had a fairly uncomplicated and quick recovery. I sometimes get a little bit of pain. You will probably never get full range of motion back side to side, but you shouldn't be in that much pain. My scar is also pretty gross. I was finally able to get my doc to admit that I formed a really nasty scar. Also, it's a bad place for nice scar healing because of the movement of the joint. Definitely get a second opinion. I hope that you get some answers soon. Maybe you could find a part time job where you can work sitting down to take your mind off things. Just try to stay positive and believe that it will get better eventually. Good luck.

 
Old 12-20-2004, 03:51 PM   #10
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

Thanks again for the encouragement everyone. I stopped posting a while back because I was so depressed and upset that I didn't even want to think about it. At least I have a little of my fight back now.

I saw the doctor again today and he explained that I have a deformity of the foot that causes it to have a very high arch and instep, but more importantly, it causes my feet to have an almost C shape to them.

This shape, he says, is what has caused my frequent ankle sprains, and the instability of the ankle joint, as well as the pain I am currently having and was having back before the ankle surgery. He pointed out to me how the bones in my foot, after the mid foot area, all curve sharply inwards. They do curve like that, but I never thought it was abnormal. I know that I have always walked more on the outsides of my feet than others in my family, but thought it was just my stride, the way everyone's stride is a bit different.

I am very confused right now and don't really know what to make of this. He gave me an ungodly painful shot of cortisone into the top of my foot in the hope that it will give me some relief and allow me to walk normally enough on my right foot that it will stop aggravating my left knee that I had a meniscectomy performed on 1 month ago.

I am just wondering how neccesary the rather radical surgery on my ankle was since I wasn't having that much pain, in the ankle itself, and how much of this could have been treated with orthotics, gait training, or other less aggressive techniques.

I don't think my doctor is surgery happy, and he certainly appears to be concerned about me and my situation. Maybe I didn't explain the pain as well as I could have, I don't know. He does do a very good job of listening to me and I like him well enough, but I am really confused.

He also said that the ankle needed to be repaired in order to address the foot issues, and he did say that there is a surgery to address a foot deformity like mine, but that he does not want to put me through that at this time, and that he certainly wouldn't do it until my knee heals and I am further along in the recovery from the ankle surgery.

After the holidays I will be getting a third opinion from a doctor who is outside of the practice that this doctor and the doc I got a 2nd opinion from.

Right now I guess I will get on with physical therapy and I am going to join a gym where I can do some excercising in the water so that I can stay a little active and so that I can lose some of the weight that I have put on since all this started. I am sure that being heavier than I should is not helping the knee or the ankle.

I just need to try and keep my spirits up and that is hard right now.

 
Old 12-20-2004, 03:58 PM   #11
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

Quote:
Originally Posted by kehorner
Wow... I'm really sorry to hear about your bad luck! It sounds like there is definitely some sort of complication going on there. I had the Evans procedure (they split the peroneus brevis and thread it through the fibula only) in the middle of last March. Thankfully I had a fairly uncomplicated and quick recovery. I sometimes get a little bit of pain. You will probably never get full range of motion back side to side, but you shouldn't be in that much pain. My scar is also pretty gross. I was finally able to get my doc to admit that I formed a really nasty scar. Also, it's a bad place for nice scar healing because of the movement of the joint. Definitely get a second opinion. I hope that you get some answers soon. Maybe you could find a part time job where you can work sitting down to take your mind off things. Just try to stay positive and believe that it will get better eventually. Good luck.
My doc has acknowledged that the scar is pretty gross. He said I will still improve some over the next few months and that there are creams that I can put on it that may help it some. He also said it could be excised - cut out the scar, pull the skin tight again, suture it and then imobilize the foot from up and down movements for a week or so until it heals.

I won't be doing that anytime soon. If it continues to hurt I may consider it down the line, but I'm ok with the knowledge that a career in foot modeling is out of the question.

 
Old 12-21-2004, 05:18 PM   #12
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

mpls...

I had the Chrisman-Snook procedure in August and have been searching for some 'stories' on how other people are recuperating. I'm just about 5 months post-op and I'm still experiencing swelling and some pain but nothing that would keep me from doing daily activities. However, I'm not able to stand for long periods of time (maybe a 1/2 hour at the most) and my flexibility is still limited to the point that I sometimes take the stairs 'side ways'. In any case, I can understand your situation...I have had 8 surgeries between both ankles and it can be frustrating. The way I look it, as long as I 'feel' better than before the surgery, I can live with that. Your surgeon should have told you that moving your foot from side to side was going to be extremely limited. Communication between you and the surgeon is imperative. You must be able to express your thoughts and opinions and insist that the surgeon listen to you. Don't allow him to treat you like just another patient. Your unique and so is your situation. Stay strong.

 
Old 12-21-2004, 06:17 PM   #13
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

I guess I made the side to side issue sound like more of a deal than it actually is when I was venting the other day. I knew going in that I would have less side to side motion after the surgery expecially since I had hyper motion before the surgery.

It does feel a little better today after the cortisone shot, but after taking my mom to the grocery store and being out for under an hour I was in agony again.

After the holidays I will be getting some more opinions on this whole high arch/pes cavus thing and the foot pain it is causing.

 
Old 12-21-2004, 08:56 PM   #14
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Re: 7 months later... Severe pain, not improving, badly depressed. Help please

Mpls21--

Can't say that I completely understand your situation, but I do understand your chronic foot woes--I have my own! A couple things you said reminded me of my situation... first of all, finding a solution for these foot problems is so tough! None of this is textbook, none of it--and I think that's tough for me. I am not at the level my OS is at, so I don't feel I can adequately make decisions with what is presented to me. Also, there is sometimes a little bit of lag time between my OS having to look though some journals before finding a solution he likes, and that has been frustrating! I am tired of opinions and consults, and want him to fix the problem because I am comfortable with him! He wants me to check out a procedure that he does not perform, and after FINALLY finding a doc in the area who does it, I was pretty blunt with the receptionist when she gave me the song and dance about the doctor and insurance, etc. I told her "Look, I do not want to do this. I like my OS, I am scared of this procedure, and I don't think it will help. I am only doing this because my OS asked me to and I respect his wishes." It's frustrating, time-consuming, and painful.

My suggestion would also be to look into some counseling/anti-depressants also. Often, people with chronic pain are put on A-Ds because they help with the same neurotransmitters involved with pain, but also becase people with chronic pain get depressed after awhile. How can you not? It affects all areas of your life! While I was very anxiety-prone, and ridden with panic attacks before my foot problems, they didn't help. Finally, about a month ago, I saw a psychiatrist and was put on Paxil--and it has made all the difference. It has made the panic attacks go away, and also made me better able to deal with the foot problems mentally.

Hope this helps and was not too difficult to understand--I am on that Christmas-time craze!

--Karyn

 
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