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  • Nerve Pain Post-Surgery

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    Old 08-03-2005, 09:35 AM   #1
    JudoBill
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    Nerve Pain Post-Surgery

    Hi everyone. To my fellow "Lisfranc club" members, I'll fill you in on how things are going, but I had a specific question for now.

    After surgery to fix a lisfranc dislocation, I have this one spot on the back of the big toe that is super sensitive. My doctor said he can't explain it because it isnt a nerve that was involved in the surgery. He told me that it could be scar tissue pressing against a nerve and that I should walk it off and that hopefully the pain would go away on its own.

    From what I have seen in other posts, this doesn't sound like a neuroma, because it isn't between the toes. Has anyone had a similar experience and did the pain go away after you started walking? Thanks.

     
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    Old 08-03-2005, 04:03 PM   #2
    WandaT
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    Re: Nerve Pain Post-Surgery

    JudoBill,

    Sorry you are having this problem...I was so hoping for good results for you, especially as your Lisfranc sprain was diagnosed and treated so quickly!

    I have discovered ‘neuromas’ can happen anywhere, not just between the toes. The ones between the toes are called ‘Morton’s Neuroma’...others are just called neuromas (or neuritis, nerve entrapment syndrome, nerve lesion, nerve compression or just nerve damage). And that what they call Mortons neuroma isn’t technically even a ‘true’ neuroma! Its just a swelling/irritation/entrapment/compression of the nerve, whereas a real neuroma is the mass of nerve tissue growing from a cut or completely damaged nerve, hoping to hook up with the other end. I found this out after being diagnosed with one on the outside edge of my foot (sural neuritis), just below my little toe...and couldn’t find much info on any besides the Morton neuromas during my first searches.

    Then from clues I got from the first searches, I did some searches on nerve compression, nerve entrapments, nerve decompression surgery, traumatic peripheral nerve lesions and found out a lot more on the subject. If you are at all squeamish, skip reading up on nerve decompression surgery and fasciotomy.

    It may have been that during surgery some of the nerves on top of the foot were cut (unavoidable sometimes) and a true neuroma is forming, or a nerve in the surgery area has become entrapped in scar tissue (common after surgery) causing pain.

    Is the pain right on top of your big toe, or is it more between the big toe and next toe? Since my fall, I have had the most annoying, creepy feeling between my big toe and the next one. Feels like millions of tiny worms are hatching and wiggling madly in there. Whenever something touches the top of my foot where the Lisfranc sprain is, it gets worse. The foot dr. said it is “deep peroneal neuritis”. Doesn’t hurt, but sure feels creepy.

    And now that the new physiatrist has discovered that my fibula on the wounded right leg/ankle/foot is subluxed (slightly dislocated), she is thinking that I have another nerve entrapment of the peroneal nerve(s) just below my knee, causing all the pain on the outside edge of my lower leg.

    So, you can have nerve problems like these wherever there are nerves. If you need some help finding info, let me know...have quite a few good links.

    wanda

     
    Old 08-04-2005, 04:44 AM   #3
    JudoBill
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    Re: Nerve Pain Post-Surgery

    Wanda,

    Thanks for your reply.

    The pain is on the right side of the left big toe on the back side of the "knuckle" of the toe. I went to physical therapy yesterday and when she massaged that spot it seemed less sensitive than before. She said that was a good sign and that perhaps massage to break up the scar tissue would eventually make the pain go away. A week ago if I lightly ran my hand over the spot I felt pain. Now, you have to press into the spot to get the same pain. I hope she is right and that it will not turn out to be a problem.

    Otherwise, all is well. The doctor said I could start putting weight on the foot last Friday (still with the crutches)- 8 weeks post op. The therapist worked with me yesterday on walking with one crutch (much harder than it looks and somewhat scary after not putting any weight on for so long). I am hoping to be off the cruthches completely by the end of next week. I have to stay in the boot until the first part of September. Aside from that one spot on the toe, I don't really have any pain, but the swelling is still tremendous. It is like looking at someone else's foot (who is much heavier than me and has much darker/redder skin)!

    I hope your nerve pain isn't getting you down. How is everything else with your foot?

    Bill

     
    Old 08-04-2005, 07:47 AM   #4
    WandaT
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    Re: Nerve Pain Post-Surgery

    JudoBill,

    The fact that it is getting less sensitive sounds good! You must be healing quickly, to be allowed to bear any weight so soon! Glad you don’t have much pain. Did you have a lot of pain before the operation...and is that pain gone now? From what I have read, the swelling will be with you for quite some time, maybe up to a year.

    Not so good here. You can skip the next part...I just need to vent.

    Finally got the dr.s office to get the reports in to the insurer so they could approve my new MRI. Had that Monday and have to see the new physiatrist next Wed. Will probably end up firing her and just giving up on the medical profession. On my second to the last appt., she asked if I needed any refills. Said no, still had one refill on the Lidoderm patches and Vicodin prescribed by the last physiatrist. Have a lot of serious drug allergies causing me to go into anaphylactic shock and possibly die. So, I am terrified to take most drugs, and only took the Vicodin about once every 3 days when I just couldn’t bear the pain anymore. Told her the Vicodin just wasn’t working as well as it had, and could she recommend anything else. She wanted me to try a trial of Topamax, but had none in the office, so gave me Zonegran. Got home, looked up Zonegran and discovered it was a sulfa drug...which would put me into anaphylactic shock and possibly die. So, before I called her, also looked up Topamax and discovered on of its effects is to decrease sweating and possibly cause dangerous overheating. Since I have never sweated and get heatstroke very easily (and this is in my record), didn’t think it would be a good idea to take that, either. Called to tell her, but the office is always closed Fri. and they were on vacation for the next 10 days. Tried to get my last refill of Vicodin, but pharmacy couldn’t because the scrip was over 6 months old. When they got back from vacation, called to tell them and they said to come in. Told the dr. (nicely) about the mistake giving me Zonegran when I am deathly allergic to sulfa drugs and gave her the samples back. First she told me you can’t be allergic to sulfa, then said she would have to check with her drug rep. So then told her about the Topamax effects of body temp/sweating and reminded her of my heat intolerance, and that I would prefer not to risk that. Asked for a refill of my Vicodin - and she said no. Hemmed and hawed a bit then said it also affects sweating so I shouldn’t have that either, and would just have to go all natural...try a heating pad!!! I was just appalled. I had been taking the Vicodin for about 8 months with no problems. Was looking for more pain relief, not less! So, checked the full prescribing info sheet then contacted Abbott Labs, the folks who make Vicodin - and they had never heard of it causing problems with sweating.

    Hadn’t thought the Vicodin was helping that much, but since then, the pain has gone from a 4-5 to 6-7, my sleep has deteriorated even more, have yelled at my precious puppy a few times and messed up my checkbook 3 times causing overdrafts (first time in 30 yrs.). Can’t even sleep with my husband except on weekends, because my tossing and turning and waking up whimpering every 40 minutes or so disturbs his sleep...not good because his income is all we have right now.

    Plus, she doesn’t seem to be in any hurry to treat anything. When I ask what we are going to do, she says “You aren’t ready for that yet. First we have to get this broken foot bone fixed”. That is pretty scary when everything I have read about Lisfranc sprains and RSD say you have to treat them immediately...and it has already been 14 months (although she has only seen me for 1.5 months). Even so...

    Sorry about the rant!

    wanda

     
    Old 08-04-2005, 08:25 AM   #5
    wakkochic17
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    Re: Nerve Pain Post-Surgery

    sounds like you need a new doc Wanda.. the fact that she didn't know one can be allergic to sulfa drugs would scare me!! I believe most docs don't have a clue on the side-effects of most drugs. It's scary that they don't pay attention to those things. Many times I have gotten drugs home and they give reference to interactions with drugs I am already on! and ones that the doc knows about too!

     
    Old 08-05-2005, 06:56 AM   #6
    WandaT
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    Re: Nerve Pain Post-Surgery

    wakkochic:

    Thank you! I have been dealing with docs and drug allergies all my life, and it sure is frustrating. Usually they just won’t believe I am as allergic as I tell them...not tell me that there is no such thing!!! I am going to politely confirm that is actually what she said at my appt. this coming Wed. - then lay down the prescribing info sheet from the manufacturer on Zonegran (that I got from my pharmacist). And gently point out the first contraindication listed is “Zonegran is not right for everyone. You should not take Zonegran if you are allergic to sulfa drugs”. If the company that makes the drug acknowledges sulfa allergy, I think that is all the ammo I need.

    Doubt if I will bother finding another doc...this one is the 6th I have seen in 14 months and didn’t have any better luck with the others.

    wanda

     
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