11 weeks Post-Op: Pain, Shoes and Doctors disinterest
Posted by terencemc on May 6, 2014
Well, it’s been an interesting few weeks. I’ve made quite a bit of progress in PT yet my pain in the foot persists and what I wouldn’t give for a 7 hour night of sleep!
First off, I should report I’m now done with crutches, just lost my boot yesterday. So, i’m in two shoes, the left (recovering) one with a wedge in it. This is great and exciting as I feel like i have much more freedom now, even if i have a substantial limp.
Also, on the positive front, my Achilles feels great. My passive ROM is beyond neutral and it feels more and more normal each week.
On the downside, since late March (5-6 weeks now), I’ve persistently experienced burning, stinging, "shocks", numbness and other pain in the foot. In recent weeks, it seems, although unconfirmed, it seems to be hindering my ability to progress with my Active ROM. So, I can’t "pull" my foot any closer to neutral than I was 3 weeks ago. I’m also, for the last week, experiencing a gimby big toe on that foot. By that i mean I can pull 4 of the toes up, but that one i can’t control. It just flops there. So, my walking is odd in that I feel the foot flopping on the ground with each step.
My PT is concerned and referred me back to my surgeon, who has no interest in seeing me as he is just saying "nothing happened during surgery to cause this." So, he’s pretty much washing his hands of it. I’m sort of at a loss with where to go next. my PT is saying it’s "beyond the scope of what should be normal now" and that I should be seen, but who should I see if not my surgeon?? it feels like nerve pain, but seems so obviously connected to my surgery/injury recovery. So, that part is rather frustrating these days as I fight through.
May 6th, 2014 at 11:17 am
I’ve had persistent numbness in my foot (pins and needle feeling) mostly in the front around the toes. I have full range of motion and movement, so its been more annoying than anything else. My doc told me in my week 2 visit that it was likely due to the nerve block and would go away in 3-6 months on its own. It really hasn’t gotten any better yet at 11 weeks.
My suspicion is that the swelling and scar tissue around my repair are impinging the nerve that runs across the top of my foot and goes to my toes. Looking at anatomy diagrams, it seems like that nerve is the culprit and it does run by the achilles. I don’t think the surgery could have affected it so its probably just a result of the extra mass in the area. I do think it gets worse if I’m on my feet all day and the swelling increases.
May 6th, 2014 at 11:44 am
Hi Terence(mc) - do you have a primary care physician? In my area (Boston) the model seems to be- for obvious surgery related questions check in with the Surgeon’s office. For anything else, any “new” pain (tho I do agree that it can be hard to separate fall-out from the injury and surgery from the new stuff) check in with Primary care doctor who will then either communicate with surgeon, or refer to other specialist. It does seem to me like since it is your foot, your Orthopedic surgeon should not be washing his hands of the deal. I mean, shouldn’t he be at the least ordering X-rays to see if anything new has happened? Or if you have a primary care physician, maybe he or she can order new imaging or request your OS or other OS if available the same. Just some thoughts.
good luck!
Jon
May 6th, 2014 at 12:53 pm
My Dad made a bundle fixing and selling electrical equipment. But he used to joke that he envied surgeons because they got to bury their mistakes. OSs who do ATRs don’t have that advantage, but it sounds like yours wishes he did. I’m with your PT, this doesn’t seem right. Not sure what the clinical solution is, but I’d appeal to other MDs - your PCP/GP as Goldman suggests, and a second OS if you can get to see one.
Good luck! This is a tough enough recovery when things go smoothly.
May 6th, 2014 at 12:53 pm
Thanks for the input! @Smick- interesting you bring up the nerve block. Mine was botched before my surgery. I say botched because it only numbed half my leg and the anesthesiologist kept telling me something was wrong and didn’t know what as he checked on me 20 times. I think it has to do with that and have to believe at this point it’ll eventually pass. But, i’ve been static in the issues for so many weeks that my faith on it magically getting better is waning. @Jon- thanks for the reco. I was trying to think what kind of doc i should see next and the PCP may make the most sense here. At least to get out of a non-referral hell. I have my next OS follow up a week from thursday, but my physio doesn’t want it to wait that long…
May 6th, 2014 at 2:05 pm
Thanks Norm. I think you’re right about this OS’ wishes!
May 7th, 2014 at 4:00 pm
Can you get a referral to a different OS? It sure doesn’t sound right, especially the floppy big toe part. I did have slight numbness at the top of my big toe, but it has resolved (I’m about 6 months out).
May 8th, 2014 at 9:20 am
Don’t know if it has anything to do with what you’re experiencing, but that reminds me that the first thing the ER doctor did for me the night of my ATR was tickle the bottom edge of my big toe and the bottom edge of my little toe to check for nerve damage. Although I didn’t have surgery, I have read it is common with surgery. Personally, 7 weeks in, my big toe has a completely different range of motion than my other toes, which are fine, due to being locked in the boot. It also has a slightly numb feeling that comes and goes depending on how long I’ve had the boot on. Nerves do regrow in a lot of cases though. My wife had a case of some neuropathy in her lower legs and it got significantly better with high doses of B vitamins and omega 3’s. Diabetes can also cause a similar condition, most people don’t know they have that.
Just some ideas.