Cassadine5

Hi.

On Nov. 1, 2004, I had an Achilles Tendon Reconstruction with HFL transfer on my right foot.

Past History: I had surgery to remove a Haglund's Deformity aka Pump Bump in 1999. After the surgery, I only had minor physical therapy. After constant pain, not relieved by cortisone injections, I was told that it was because of scar tissue, so I had surgery in 2001 to remove it. My surgeon said I had alot of scar tissue, and that my pain should disappear. However, I was still in constant pain, and he said that I probably developed scar tissue again. I also had severe pain in my hypertrophied scar, not relieved by injections. After continued pain, and no longer having private insurance, I had to switch doctors. I had two opinions, and both said it was probably scar tissue, so I decided to have surgery again to clean it up. However, this time, I told the physician I would have the surgery only if I had immediate and extensive physical therapy post surgery.

Present History: When I had the surgery on Nov. 1, my doctor discovered that after she removed all of the scar tissue, my achilles tendon was badly damaged and would eventually rupture if not repaired. Therefore, she did a tendon transfer using the HFL tendon (from the big toe), and repaired the achilles tendon. She also did a scar revision.

I was non-weight bearing in a cast for 2 weeks. Then I was put in a removable plaster splint for another 2 weeks. I was then put in an Aircast for another two weeks. My biggest complaint is that I have developed severe pain in the medial malleolus (inside bony part of the ankle). The pain occurs constantly, but mostly upon weight bearing, and when stretching my ankle upwards. X-rays were negative for a fracture. My doctor told me to stop using the Aircast, as she thinks that any pressure on the ankle is causing the pain. However, IMO, if that were the case, my pain would have lessened by now. I've been out of the Aircast for the past 4 days. She said that if pain did not subside, she would perform more extensive radiographic testing, i.e. MRI or ultrasound or other? I am currently getting physical therapy two times a week, with deep scar massage, and ultrasound on the scar.

On top of everything, I've also developed vascular problems, (swelling, bulging veins, pain) which sound like DVT (deep vein thrombosis). My orthopedist and my internal doctor have dismissed my neurosis. However, I was referred to a vascular specialist and I am scheduled for a duplex scan next week to check for any blockage. I am not taking any chances, as DVT can develop into pulmonary embolism, so until I get my test and results, I am taking aspirin and wear graduated stockings, which have helped alot.

I also have severe pain in my left foot because of my flat feet. I had a triple arthrodedis in my left foot in 1986 and 1994 (I had the subtaler joint fused first and then the talonavicular joint fused 8 years later) but that foot feels relatively fine compared to my right foot. I wear a jointed AFO on my left foot, but was just fitted for a new one to alleviate the flat foot pain.

I am becoming depressed because no one can give me any answer as to why this pain is occuring. I have been unemployed since August 1999 because of these problems. Fortunately, I was just approved for disability, so that will help my financial problems, but I would still like some answers about the pain. I've been unsuccessful in finding results online. It sounds like there may be some impingment issue, but I'm not sure.

I would deeply appreciate any feedback on this issue. Thank you.

Wilma