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Old 08-27-2012, 01:27 PM   #1
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Surgery or no surgery?

On June 12th I was trying to take a picture of a bunny in our backyard. Instead I found a hole (probably made by same said bunny) using my left ankle. It hurt like the beejeezus when it happened and I went to a doc in the box who told me that it looked like I chipped a bone and gave me one of those lovely boots to wear. Anyone else get the version that weighs 300 pounds by the end of the day?

I went in to see an Ortho who was recommended to me by a friend. I couldn't get in to see the one she recommended but figured seeing another doctor in the same practice would be ok. Wrong....

At first he told me that there was nothing wrong with my ankle other than a bad sprain and that I would just have to wait until it got better. A couple of weeks go by and it's no better. He prescribed for me a cream that had to be specially made (cost $500!!!) and told me to wear sneakers all day until my ankle started hurting and then to put the boot back on again. Another couple of weeks go by and still no better. He sends me for an MRI with a .6 Tesla. Comes back and says that I have an Accessory Ossicle of the Navicular Bone. That is what the other doctor thought was the bone chip. Tells me to keep on the with boot and sneakers routine.

Two months after the initial injury and not feeling any better I decided that he needed to be fired and someone else needed to take a look. Found an absolutely wonderful doctor who pretty much said that the boot wouldn't help my injury and that the cream wasn't going to help either. He said that Aspercreme would work better for me. Also the MRI should have been done with a 1.5 Tesla because with a .6 you can't see much in the way of detail.

When I first went in to see him I couldn't but barely walk. A woman who looked to be about 100 years old smoked past me in the crosswalk to his office. He put me in a figure eight ankle stabilizer and I could suddenly walk with much less pain. He said that I have PTTD along with the extra bone on on the Navicular Bone.

It's been a week since then and I seem to be going backwards again. I can walk but the more pressure I put on my left ankle the more it screams back at me. He gave me a prescription for Mobic and I've been taking that and following his other directions but I still seem to be getting worse. At this point I am extremely frustrated as it's coming up on three months of not being able to walk well or without pain.

My question is this, has anyone else gone through this sort of getting better then getting worse scenario? Did you have surgery and did it help? I know that surgery is not always the best answer but if it would help I would welcome it with open arms.

Thoughts?

 
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Old 08-27-2012, 02:57 PM   #2
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Re: Surgery or no surgery?

Did you get and read a copy of your MRI report? I always get not only that but a copy of the actual films (or CDs, now), as well.

I'd say that although it's been a while, it HASN'T been very long since you saw the last (and best, according to you) doctor, so it makes sense that it will take even longer still to heal because of that diagnosis delay. Are you on your feet excessively or in demanding ways (sudden stops or changing directions, lifting things)?

I'd give it a bit more time, ice and elevate as much as possible, take the Mobic to keep inflammation down so it can heal, and stay off it as much as possible. If it continues to get worse instead of better despite all that, call the new doctor and let him know.

 
Old 08-27-2012, 03:02 PM   #3
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Re: Surgery or no surgery?

I initially sprained my ankle in April 2010. Soft cast and pt didn't help much and by fall the whole arch fell. Tried a brace for several months but eventually had to have surgery (June 2011) OS said pt tendon pretty much torn through by then. A year later foot is doing very well. Be sure to get the best you can to do the surgery since there can be a lot to it. I went into NY to HSS and had it done.

 
Old 08-27-2012, 03:29 PM   #4
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Re: Surgery or no surgery?

I'd be pretty aggressive about seeking treatment if I had to do it all over again. I initially acquired PTTD from working out after minor knee surgery. Figured it would just get better with time. When I finally did get to the doc I just took the NSAIDS and didn't do the exercises. That combined with my job (on my feet all day, lots of lifting) and a go around with plantar faciitis made the condition progress rather quickly.

Long story short...if I knew then what I know now? And what I'm about to go through with surgery? I'd be getting 4th and 5th opinions. You do not want to mess with this. Good luck and keep us posted!

 
Old 08-27-2012, 04:23 PM   #5
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Re: Surgery or no surgery?

Quote:
Originally Posted by pclare View Post
Did you get and read a copy of your MRI report? I always get not only that but a copy of the actual films (or CDs, now), as well.

I'd say that although it's been a while, it HASN'T been very long since you saw the last (and best, according to you) doctor, so it makes sense that it will take even longer still to heal because of that diagnosis delay. Are you on your feet excessively or in demanding ways (sudden stops or changing directions, lifting things)?

I'd give it a bit more time, ice and elevate as much as possible, take the Mobic to keep inflammation down so it can heal, and stay off it as much as possible. If it continues to get worse instead of better despite all that, call the new doctor and let him know.
Got a copy of the MRI and the X-rays. Side note: how cool is that that you can get a copy of your X-ray or MRI to take with you? I can remember having to make arrangements to go get the film and it was such an ordeal. The MRI said all is well except for the extra bone part. The extra bone and that it still hurts like the dickens. I honestly think that there has to be something that was missed. I mean how can I still be having pain if everything is ok.

I'm an exec assistant so I sit most of the day. My boss has now started to chastise me if I walk into her office To tell her something instead of calling her. She's like an Italian grandmother except instead of telling me to "eat, eat" she tells me to "sit, sit". And I live with nurse ratchet who hollers at me if I even think about trying to walk around without my brace and shoe on. He really is a sweet guy but heaven forbid if I try to miss a dose of antibiotics or do something the doctor told me not to do....

 
Old 08-27-2012, 04:31 PM   #6
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Re: Surgery or no surgery?

Did they tell you exactly what is wrong with your ptt, I know you said pttd but is there any tears? Sometimes with pttd, if it is caught earlier enough it can heal. Prior to being diagnosed with pttd, I went several weeks in a boot then the doctor said "all better" Went 9 months where it would feel great then hurt like heck. I got to a point where the inside of my ankle felt good but the pain was on the outside. Found a new doctor and after trying the boot and a cast, finally brought in a different surgeon from his office who looked at the MRI and did some tests (could not do a single heal lift) decided I needed surgery. Given the choice of surgery or no surgery, I would definitely opt for surgery. Recovery is long and difficult but in the end totally worth it.

 
Old 08-27-2012, 05:10 PM   #7
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Re: Surgery or no surgery?

Quote:
Originally Posted by swimbunnie View Post
Be sure to get the best you can to do the surgery since there can be a lot to it. I went into NY to HSS and had it done.
Everyone that I mention his name to has either had him as a doctor or knows someone who has. They all rave about him. He has done surgery on a couple of other people I work with and they have all been thrilled with his work. Even the woman who isn't pleased with anything raves about him. His wife works at my company and I'm guessing she has done a ton of referrals. I can tell you that he is incredibly intelligent. In addition to all of his board certification etc. he also has an MBA and a Masters in Engineering. Geeky little guy but nice as can be.

One thing I can say that I definitely liked, make that loved, about him is how considerate he is of his patient's time. He came in the room about five minutes after his coordinator left and apologized for making me wait. He looked at my knitting and said that he was glad I had brought something to do so I wasn't just sitting waiting on him. Then after he moved on to the next patient he walked by the room again and asked if I had gotten my brace yet. When I said no he got his coordinators attention and said to page the guy again because I needed to get back to work and couldn't just be sitting here.

Oh and can I tell you how nice it is to work with your doctor's wife? On Friday I was waddling through the lobby and she saw me and asked if i was not doing any better. I said not so much. She asked if I had called her husband and when I said yes but he didn't have any appointments until September 10th. She just shook her head and said no, when can you make it over to the office. About ten minutes later I got an email with an appointment time. I feel bad for having kind of burst in on their time so I'm going to pick up some cupcakes for the office. Normally would bake them but not so great at the standing right now.

 
Old 08-27-2012, 05:19 PM   #8
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Re: Surgery or no surgery?

Quote:
Originally Posted by ginger62 View Post
I'd be pretty aggressive about seeking treatment if I had to do it all over again. I initially acquired PTTD from working out after minor knee surgery. Figured it would just get better with time. When I finally did get to the doc I just took the NSAIDS and didn't do the exercises. That combined with my job (on my feet all day, lots of lifting) and a go around with plantar faciitis made the condition progress rather quickly.

Long story short...if I knew then what I know now? And what I'm about to go through with surgery? I'd be getting 4th and 5th opinions. You do not want to mess with this. Good luck and keep us posted!
If he does come back with a recommendation for surgery I will definitely be getting a second opinion. I've had other surgeries, the worst being an Ulnar Nerve Transposition which seems like recovering from a bad hangnail in comparison to foot surgery.

 
Old 08-27-2012, 05:28 PM   #9
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Re: Surgery or no surgery?

I agree. A good rapport with your surgeon makes a world of difference. I finally found someone I trust and made me feel so much more at ease with the decision to have the surgery. Keep posting, there is so much info and so many caring people on these boards. It really, really helps.

 
Old 08-27-2012, 05:42 PM   #10
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Re: Surgery or no surgery?

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Originally Posted by Missyluke View Post
Did they tell you exactly what is wrong with your ptt, I know you said pttd but is there any tears? Sometimes with pttd, if it is caught earlier enough it can heal. Prior to being diagnosed with pttd, I went several weeks in a boot then the doctor said "all better" Went 9 months where it would feel great then hurt like heck. I got to a point where the inside of my ankle felt good but the pain was on the outside. Found a new doctor and after trying the boot and a cast, finally brought in a different surgeon from his office who looked at the MRI and did some tests (could not do a single heal lift) decided I needed surgery. Given the choice of surgery or no surgery, I would definitely opt for surgery. Recovery is long and difficult but in the end totally worth it.
He didn't say exactly what was wrong and the MRI didn't show anything but I still think that is probably because it wasn't ordered with a strong enough power to show a tear or anything like that. He looked at where I was having pain doing the press "does this hurt" press a little lower "does this hurt". He asked me to stand on each foot and try to go up on my toes. Right foot, no problem. Left foot, about fell over. He said that as soon as I put on the brace we would see if it was a PTTD injury or not. Put on the brace and I was like tiny Tim. I could walk!

 
Old 08-27-2012, 06:03 PM   #11
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Re: Surgery or no surgery?

Quote:
Originally Posted by ginger62 View Post
I agree. A good rapport with your surgeon makes a world of difference. I finally found someone I trust and made me feel so much more at ease with the decision to have the surgery. Keep posting, there is so much info and so many caring people on these boards. It really, really helps.
Having a doctor who seems to really care does makes a huge difference. There is a term, psychoneuroimmunology. Basically if you believe you will get better you will. If you don't then you won't. A group of people getting chemo were asked to draw what was happening to their bodies as they were getting the chemo. Those who drew it like warriors fighting or golden rays of sunshine hitting their bodies got better. Those that drew it like a black cloud or something else negative didn't get better.

All of this to say anything that you can do to feel better and more positive about your treatment is a good thing. Having a great medical staff is key but having people you can talk to that understand is wonderful. Very happy I found this forum. The posts that over read so far show a lot of caring people. Thank you all for your replies, help and suggestions. Greatly appreciated!

 
Old 08-28-2012, 04:05 AM   #12
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Re: Surgery or no surgery?

The one thing I would caution you on however is if you need surgery please be sure that your doctor has done many of these procedures. The surgery is a complex one and you need to be sure that the doctor is well qualified to do it.

 
Old 08-29-2012, 07:19 AM   #13
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Re: Surgery or no surgery?

Went back to my doctor yesterday and didn't really get very far. From the physical examination he was worried that I might have a blood clot so he sent me over to get that looked at right away. I don't have one, thankfully.

When I met with my doctor yesterday I showed him a bruise that I have had for a week. This bruise has stayed the same color and shape for a week so I'm thinking that's an issue. He said that the spot where the bruise is located is where the muscle ends that is connected to the tendon that is injured. Has anyone else had bruising like this?

Now I'm asking for another MRI (with a stronger resolution) to find out what is happening. I feel like I'm kind of pushing this but it seems like I'm just getting worse and my fear is that I've had a small tear on the tendon and the longer I go the more it's going to tear until it's really bad.

Anyone else out there had difficulties getting a final diagnosis that has any suggestions?

 
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