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    Old 04-03-2006, 03:30 PM   #1
    RubyRedHead
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    Foot pain - arthritis - surgery??

    Hi Everyone,
    I am new to the boards and this is my first entry. So happy to have found this site and am sure I will get great information from you. Thanks in advance!

    I've been reading postings about foot issues especially those concerning arthritis in the big toe and surgeries to correct those issues. I had my first visit to a podiatrist a couple of weeks ago, and after viewing my x-rays, the Dr. says that the only way to help my issues is surgery. Wham, bang! My symptoms were pain and swelling in my left foot at the first joint and similar pain in the right without the swelling. Movement is very restricted and it kills to tip toe. I was aware of arthritis in my left foot: loss of cartlige/bone spurs and major swelling. Have had cortisone shots for these symptoms for the last 3 years. Finally sought help when my right foot started showing similar signs. X-rays showed bone to bone wear in both feet. I was so in shock when his response was surgery! He started talking about trimming bones/plates/screws....overwhelming. Probably didn't leave with enough information due to the shock factor. Left with a perscription for diclofenac - 75 mg 2x/d (generic for voltaren). Have been taking med as perscribed without much relief. Have been searching the web since for sites such as this. I need help from those of you who have similar problems and what you have done to "get fixed". I would greatly appreciate any comments/suggestions/advice you may have to offer. Until now, I felt like I had drawn the short straw.....I'm so happy to be here!! Please enlighten me!
    Thanks!

    Beth

     
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    Old 04-03-2006, 04:05 PM   #2
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    Re: Foot pain - arthritis - surgery??

    Here's what you need to do. I don't know where in NC your city is but is it near Charlotte? If so, call the Panthers front office (they're a pro football teamt) or the nearest major university with a football or basketball team and see who they send their players to for "turf toe." That's the person you need to go see. You probably have hallux limitus or hallux rigidus. It is commonly called turf toe, runner's toe, tennis toe, etc. The first surgery for that is a cheilectomy. They go in and remove the bone chips and spurs and shave down the lump on top. If it's real bad, they may have to put in screws. When the cheilectomy no longer suffices, then you can go to an implant....like a joint replacement. Don't worry about the cheilectomy..I had it alomst 3 years ago and I dance, jog, wear heels, have no trouble. I'm not sure of the drug you are on but am surprised he didn't give you celebrex or mobic as they are the common drugs. Let me know if you have any questions. Good luck. (Oh, and Shaquille O'Neal had this surgery and played basketball 6 weeks later!)...

     
    Old 04-03-2006, 04:47 PM   #3
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    Re: Foot pain - arthritis - surgery??

    Thanks for the quick reply! I've been reading your advice in several posts (threads?? Not sure of the terminology yet.) My x-rays show that I already have bone to bone contact where the bones are wearing each other out. Not much cartlidge left between them. My right foot's bones are not aligned properly where the bones have been rubbing each other. I don't have much of a lump on top. The Dr. didn't mention any names of certain types of surgeries but I have been researching those you mentioned. He told me that the only fix for me would be surgery because my symptoms will only get worse. He described one type surgery on the left foot and another on the right which would involve pins and screws. Sounds like fusion to me on the rt. I've been reading too many horror stories about surgeries and am not sure that I am ready or know enough information to go there. I've also seen the "Stages...I,II,III" mentioned in several posts and don't know what that means. I am in Winston-Salem, about 80 miles from Charlotte. Any other ideas about what's going on with my feet? Should surgery be in my near future? I realize you are giving your personal thoughts and insight. At this point, I can use any information that I can get. It's greatly appreciated!

     
    Old 04-03-2006, 06:35 PM   #4
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    Re: Foot pain - arthritis - surgery??

    Beth: If you've lost a lot of cartilege, then, yes, surgery is the only option. It doesn;t grow back. If the bones aren't aligned properly then he's talking about some sort of bunion type surgery and that could call for screws or an osteotomy which might also call for them. I really would try to find a sports medicine oriented doc...be it podiatrist or orthopaedic surgeon. Call the athletic department at Wake Forest...see who they use...check with the basketball office, not football...hey have the better program. Good luck...

     
    Old 04-04-2006, 09:16 PM   #5
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    Re: Foot pain - arthritis - surgery??

    Did some research today and found out the Dr. at WFU that the athletes use. Hopefully I can get a second opinion within the next week or two.

    I am on the pod Dr's. surgery schedule for April 26. I am so reluctant to have this surgery. The reason I scheduled it so soon is the predicted recovery time. I need to be walking by the time my kids get out of school and summer vacation time is here.

    I hate to think that I am rushing into this plus I don't want to be worse off after the surgery. Maybe I've been reading too many unsuccessful entries. After all, my left foot has given me trouble for years and I have dealt with it. But then again I'm not getting any younger and how much damage is being done now that will only multiply in the future? I keep having this conversation with myself about the pros and cons and am very confused. I don't know what to do. Any thoughts?

     
    Old 04-05-2006, 04:14 AM   #6
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    Re: Foot pain - arthritis - surgery??

    All I can tell you is my experience. I had a cheiletomy, no screws, plates, etc. I walked out of the hospital and was in bed the rest of that day...painkillered up! The next day I was up and about but taking it easy due to the pain meds. Next day I drove to get my nails done and by the office to check messages, etc. Then it was the weekend. (Had surgery on Wed). Went back to work full time on Monday. So there was really very little down time. In fact, I cold have worked that Saturday if it had been a work day. So I was up and about quickly, walking on the foot. That's one reason I am sending you to the sports doc. They tend to do things that will get you on your feet faster as that's their goal with the athletes. And you are right...this is not going to get better on its own. If you let it go long enough you'll end up getting the toes fused and then you'll be in a really bad place insofar as heels, running and other such activities. And that's the end of any treatment.

    And I would NEVER let anyone operate on me that didn;t give me the specific name of the surgery procedure AND draw me a picture of exactly what he planned to do...as well as give me his track record with this and tell me exactly what the recovery process is and the next option if this doesn't fix the problem. You really don't have enough information about what he plans to do. And don't just call and ask the nurse.
    Ask to speak to him and just say you don't feel comfortable with what he told you and you need more info. Good luck. This is VERY serious surfery in that these are the only feet you;ll ever have and you must have the right person operating on them.

     
    Old 04-07-2006, 10:30 AM   #7
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    Re: Foot pain - arthritis - surgery??

    Hi Beth,
    I just wanted to chime in on surgery in the foot for arthritis pain. I developed arthritis after a bad ankle break/sprain in my right foot. Years later, I was told I had arthritis in my foot (not where you have it but more the midfoot). I actually had several surgeries prior to developing the arthritis but in the end, my surgeon said that a fusion was the definitive solution. I knew that a fusion can mean loss of motion but after years of pain and instability, all I wanted to do was walk and be active again. The prospect of surgery is scary, especially with a long recovery, but to me it was far more scary to have chronic pain and no options!!!
    Also, you need to find out how the fusion would limit you in terms of motion. My surgeon made it clear that I would loose side to side motion in my foot- and I did- but I also was pain free for years. Unfortunately, I developed arthritis in a nearby joint as a result of that fusion and had another fusion last June. I did have a non-union but that is unusual and I dont want to scare you. Just realize that it is always good to have choices. Let me know if I can be of any help!

     
    Old 04-07-2006, 02:52 PM   #8
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    Re: Foot pain - arthritis - surgery??

    D,
    Thanks for the input. The fusion thing with loss of movement is what worries me the most. Since my first Dr. visit, I have been doing research and have questions this time to take with me when I get another opinion. Hopefully I will get my second opinion on Monday. Was told to call early a.m. to see if any cancellations have come up with this second Dr., the one that WFU athletes use.
    This whole thing has just hit me like a brick. I've dealt with pain, but how do I know if it is as bad as it gets? My pain tolerance is pretty high. I pursue this because I don't want any other body parts to start making adjustments to compensate for my feet...I don't want to be totally out of line! But then again, I don't want to be worse off than I already am.
    Ain't aging the greatest!! lol. I don't feel old, my kids tease me about getting old....I am 45 and on most days feel about 30. Anyway, thanks for "listening" and taking the time to reply.

     
    Old 04-08-2006, 07:07 AM   #9
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    Re: Foot pain - arthritis - surgery??

    Glad you're taking a list of questions with you. That will help you a lot. I'm 60 and am very active. I just refuse to go the fusion route unless it gets to where I can't walk at all! I need the ROM (range of motion) to do the things I enjoy. And I think I made the right choice. This surgery should last me a good while.

    And you are right about getting your body out of whack from all this. My left hip muscles still tighten up sometimes from all the compensating I did before. When you have the surgery, be sure to wear a shoe on the "good" foot that is the same thickness of sole as the boot you have on the surgery foot. It will help you walk more level and straight. I wore Merrell's that really worked well.

     
    Old 04-11-2006, 08:19 AM   #10
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    Re: Foot pain - arthritis - surgery??

    Update - was not able to be squeezed into Dr. #2's schedule yesterday. Was on standby, ready to go at any moment's notice. Will see Dr. #1 on Thursday (his nurse tomorrow for pre-op stuff). Will go with mega-questions and expect MEGA-answers. Will let you know how it goes.

    I did go off the pain meds which I was taking as directed (from Dr. #1), on Friday, to see if they really were doing the trick for me and to let Dr. #2 have an unmedicated patient to exam. Couldn't sleep Sun. pm and held off till last night before taking a pill. I've found that they really do relieve the pain. It was just wishful thinking that I was miraculously healing. Will get back with a report asap. Thank you all for your input...any more suggestions for the upcoming appts?

     
    Old 04-15-2006, 03:58 PM   #11
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    Re: Foot pain - arthritis - surgery??

    Still out there???
    Went equipped with my questions to see Dr. #1. Actually I went two days in a row! Saw the nurse one day and the Dr. the next. Doc told me that the procedure is the same as done for a bunionectomy (cheiletomy) - cleaning out the spurs & stuff between the bones. Since my lack of cart, he will cut the bone and reset it and position it with perm screws allowing a larger space between the toe bones thereby allowing more flexability. He's talking mm's., not inches! Two weeks in a boot then tennis shoes in the 3rd week (sure this is if all goes as planned).
    If I did nothing, it would only worsen and be harder to fix with longer recovery. I feel much better about it and this was also solidified when I learned that the doc lectures all over the country about this very surgery.
    He showed me x-rays and pointed and explained it all. Guess I gotta have faith. Then, I'll probably get the left foot (which has extra problems) done at the end of the summer.
    I feel much better about it and will see Dr. #2 if at all possible to fit me in before surgery on the 26th. Did my homework - probably too much. Whatdaya think??? Anything I should know that I can do in advance to make life easier for the family? What are your suggestions about bathing/showering? How yucky is the bandage after two weeks?? Any tips there? Anything else I should be prepared for? Tell it like it is!!!
    Thanks!!!

     
    Old 04-16-2006, 03:12 PM   #12
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    Re: Foot pain - arthritis - surgery??

    Well, since i was up and walking day of surgery I would assume you will be also but I didn't have screws so I don't really know. And it was my left foot, so I could drive.
    As for shower/bathing, they can give you a cast cover - a rubber thing to put over your bandage so you can bathe or shower. It works great. Ask if they do that. If not, you can buy one at the drug store. And I went back after one week for a bandage change. It wasn't yucky. There was no blood on it so no big deal. It just got dirty around the toes because that was open to the air. I had one of those velcro booties with the wood bottom.

    As for shoes, ditch the sneakers idea. It's not solid enough and hard to get into. Get a pair of mule type (slip in) Merrell's (Primo Breeze is one style) or Danskos, etc. Like a clog...but more fitted. I wore two different pairs of Merrell's and the sole was a good height for the good foot when the other had the bootie on.

    Hope you get in to see the second guy just to get his take on it. The screws concern me as that's not always done with a cheilectomy (mine wasn't). But he may be right.
    Just wondering.

    Good luck and keep us posted!

     
    Old 04-19-2006, 11:26 AM   #13
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    Re: Foot pain - arthritis - surgery??

    Hi Rubyredhead,

    I got your message and read your thread. Like you, I'm only 40 (41 next month), pretty active with children to take care of. What happened to me was that I have had bunions all my life, I think I was born with them! They would bother me sometimes, nothing Ibu didn't help.

    Last July I started on the treadmill to lose some weight and after a few days I had a sore spot in my arch. I felt it and there was a lump in there that hurt to touch. I went to the GP and he said it was a cyst and to return if it didn't go down for a cortizine injection. The thought of an injection in the arch of my foot -OUCH!- freaked me out, and I put it off until November. The day of the appointment I was so scared I got a migraine and cancelled. Nice. When I went in for the reschedule, I was all nerved up. The doctor felt the lump (now quite large), and he said he wasn't comfortable injecting it now. Here I was all mentally prepared, and he blew me off! (I was so annoyed I now have a new doctor) He referred me to a Podiatric Surgeon who comes to my small town once a week. By the time I saw him it was December, and the lump was killing me! It turned out to be 1.4 cm! He looked at my poor feet and announced that the lump was a fibroma on my plantar fascia caused by the PF being tight for a long time due to the bunion pulling it. The only way to get rid of the lump permanently was to fix the bunion. He told me that both conditions would only worsen over time, like yours,and that at 40, I'm only half done with these feet (ha ha), and they could feel great for the next 40 years. I really didn't feel I had a choice. It had to be done. I put the surgery off until March because we are in NH and love winter sports. I also didn't want to fall on ice.

    I really was petrified of this whole thing, they actually had to sedate me three times while waiting to go into the OR! The day after the surgery I was in agony. During the course of the day I took 14 Tylenol #3's. My husband called the doctor that night, and my swelling was so bad that the dressing was too tight. My husband rewrapped it and within an hour I felt OK. That was the only real pain I had, luckily. When you first get home, if you had a local, your foot is gonna feel numb like a block of wood. Take your pain pills anyway, when it wears off the pain sets in fast. It was almost exactly 12 hours for mine to wear off. Keep it way up high and ice it lots, especially if it has lots of dressings. The cold has to get in there.

    I get my STUPID plaster cast off the day after your surgery, and I can't wait. For me the whole experience hasn't been that bad. Like I said in the other thread, I have good days, and BAD days, but I tend to be a happy camper, so I guess that's served me well. I was more afraid of SURGERY than of recovery, once that was over, I just had to sit and wait and wait and wait... You get the idea! I already have the other foot scheduled for December 1. I don't want to ruin the summer, and I need to be all ready for Christmas before I go in. I figure right after Thanksgiving should work. Plus, there is the fact that my deductible is met for this year.

    Your situation is a lot like mine, after the surgery your young feet should be good for a long time. Without it, your feet will degenerate until you need more intrusive treatment, and you won't heal as well because you'll be older. Just do what you need to be prepared, like I put in the other thread. The one thing I forgot to add was a shower chair. If you're going to be non weight bearing, it's a must. It's great that you make question lists for your dr. visits, there's so much thrown at you, you need to remember the things you want to know. Don't be afraid to call them if you think of one after an appointment.

    I think I am optimistic now because it's almost over. That, and the fact of reading these posts and realizing how lucky I am to not have a chronic recurring problem, like some people. If I had found this forum before my surgery, I would have been more afraid, if that's possible.

    I'll start a Buddy List with your ID, so we can be "forum pals", if you want. This is actually the first time I've used this forum stuff, like you I don't know much about it. If you want some support, I'd be happy to correspond with you here. I'll check this thread tomorrow, and see what you think. Feel free to share YOUR life story too (I tend to go on...)!

    TTFN, Kim (espda)

     
    Old 04-19-2006, 03:45 PM   #14
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    Re: Foot pain - arthritis - surgery??

    One week and counting... ...I keep asking myself if this is the right thing to do?? Probably is but I really don't want things to be worse after. That's one of my greatest fears. How can you ever be sure? Guess I'll just bite the bullet. It's tuff being the new foot on the block!!
    Thanks also for your support Kim. The one difference in our feet is that I have never had bunions. It's the arthritis that has done my dammage in the joints. My feet kinda have a slight bump on the top of my big toe joint that is caused by spurs and the rubbing that occurs due to the wearing out of the cartilage. Guess all of that stuff would probably lead to bunions if I don't get fixed now.
    One thing that has been mentioned in your posts is that you were put in hard casts for x number of weeks immediately after the surgery. My doc says I'll be in a boot thingy right after the surgery. He says I'll be walking on it! It's got a funky wedge (looks like almost 2" high) that covers 2/3 of the sole from behind the toes to the back of the foot. The 1/3 toe portion has nothing under it, so it sits approx. 2" from the ground. You all may know what I'm talking about and it may even have it's own namey!! lol. He's said nothing about crutches either. That kinda scares me because I've been reading about most not bearing weight on their foot for a number of weeks. That's one question I need to get clarified. I will be calling the doc tomorrow! He is, for sure, going to be cutting the 1st met. bone and realigning it (after he removes the spurs), with screws and possibly pins and dropping it down because it is raised higher, due to wear from lack of cartilage, than the big toe bone and higher than the bone that is behind the 1st met. Would that be the 2nd met? (Wish I had taken anatomy.) Does that make sense? I understand from seeing the xrays what he's talking about. I'm not so sure what his reasoning is by walking on it, but it seems like you wouldn't want any added pressure on a bone that is trying to mend.
    Anyone ever heard of that?
    Whew, thanks for staying with me. I'm glad you all are out there! What next? Anything else I should ask or need to know? And by the way, I did get a plastic step stool to sit on in the tub. I think that will work just fine for bathing. It's almost as tall as the tub and it's a beautiful shade of pink! The 4 males that I live with will love that...I'm sure.
    I'll check back soon for comments..THANK YOU ALL!

     
    Old 04-19-2006, 04:55 PM   #15
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    Re: Foot pain - arthritis - surgery??

    I think you are better off walking on it to start with. I did so I'm inclined towards it anyway. One other thing, TAKE YOUR MEDS! Stupid me though since it didn't hurt when I got home from the hospital, I'd just go to bed and sleep. Did I wake up to pain!
    Be sure and take them the first two days...after that, you can try without but I was on them for 3 with an afternoon off so I could drive to get my nails done (I'm so vain!).
    And don't forget the cast cover...it'll work great with the stool...

    Good luck and keep us posted.

     
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