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join fusion nightmare

Discussion in 'Ask your questions here' started by Ouchfoot, Sep 6, 2009.

  1. Ouchfoot

    Ouchfoot New Member


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    Five years ago I had a large neuroma removed from my left foot. (I'd had four previous neuroma removals, all successful.) The surgeon made a spur-of-the-moment decision to fuse two toes on the same foot. One was slightly curved, the other looked and functioned normally, except that the top joint was hypermobile. It did not hurt. X-rays appeared normal for that toe. This toe is next to the large toe, and is quite long. I had SEVERE pain for nearly a year in that joint and diffuse pain across the entire foot. The doctor offered no solutions or insights. Five years later I still have pain in the fused toe with every step I take, and the diffuse pain across my foot comes and goes. It has made walking miserable. I have seen two podiatrists who offer no hope or help. It feels like I am walking on a stick. I have paid up to $250 for orthopedic shoes. Nothing helps. My closet is full of shoes that I rotate during the day. Would having this toe amputated improve my situation? Is there a podiatrist anywhere who can undo a bad fusion?
     
  2. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***********************************************************
    How do you get from having a neuroma removed to fusing two toes? Unless treatment of toe problems was discussed and approved by you prior to surgery, it seems to me a clear case of malpractice, though I'm quite sure that the statute of limitations has run by now. I would need some insight into the source of your pain. Certainly it cannot be in a joint that is no longer there, and I don't know why you would be having pain across the entire foot from a toe fusion. Better figure that out before you have a fusion undone and perhaps find it had nothing to do with it.
     
  3. Unregistered

    Unregistered Guest

    The neuroma was large enough that it was causing severe pain upon walking, which radiated to the area around my other toes. Yes, I believe it was malpractice. I just couldn't bring myself to actually sue the Dr., as he has a young family, etc. And yes, the statute of limitations ran out long ago. My guess is that the diffuse pain was caused by extended lack of blood to my foot during the lengthy procedure. When it flares up, my foot is so sensitive to any kind of pressure that wearing shoes and socks is very difficult. I was recently given Lyrica for nerve pain in my back (ruptured disk). Not only did it ease the pain in my back but improved the diffuse pain in my foot well enough to allow me to wear shoes and socks for awhile each day. The Dr. who prescribed for my back said Lyrica is used for nerve damage.

    As for the problem toe: Right after the procedure was done, I bumped my foot. The top layer of stitches split across the fused area. The Dr. was out of town, so the nurse put a band-aid type strip across it. She said she didn't know what else to do. Later when I saw the Dr. he simply looked without examining and said he could see no reason for my pain. The pain in that toe was so severe I could get no relief whatsoever, whether I was standing on it or had it propped up. The Dr. gave me several cortisone shots at the base of the toe, none of which helped. He refused to prescribe anything stronger than OTC Tylenol. I developed an infected ingrown nail in the toe next to it - - a toe that had never bothered me before. He cut the right side of the nail away, which stopped the pain in that toe.

    I will try to describe the pain I feel in the toe that was fused. When I walk, it is as though I am walking on bare bone where the joint used to be, as though the full weight of my body is pressing down where the joint used to be - - - trying to bend where it cannot. There is no padding where my toe contacts the ground. The toes around it "try" to compensate by curling under. My gait has been impaired and I now have severe joint damage in my knee. Sometimes I feel reconciled to living with this daily pain, sometimes I am angry, even occasionally in despair. There must be something that can be done. I know that amputation sounds drastic, and maybe it wouldn't help, but I would love to go shopping or walk around the block again without being in pain.
     
  4. toehurt

    toehurt Guest

    The neuroma was large enough that it was causing severe pain upon walking, which radiated to the area around my other toes. Yes, I believe it was malpractice. I just couldn't bring myself to actually sue the Dr., as he has a young family, etc. And yes, the statute of limitations ran out long ago. My guess is that the diffuse pain was caused by extended lack of blood to my foot during the lengthy procedure. When it flares up, my foot is so sensitive to any kind of pressure that wearing shoes and socks is very difficult. I was recently given Lyrica for nerve pain in my back (ruptured disk). Not only did it ease the pain in my back but improved the diffuse pain in my foot well enough to allow me to wear shoes and socks for awhile each day. The Dr. who prescribed for my back said Lyrica is used for nerve damage.

    As for the problem toe: I was told I could walk on it as I pleased after 48 hours. Right after the procedure was done, I bumped my foot. The top layer of stitches split across the fused area. The Dr. was out of town, so the nurse put a band-aid type strip across it. She said she didn't know what else to do. Later when I saw the Dr. he simply looked without examining and said he could see no reason for my pain. The pain in that toe was so severe I could get no relief whatsoever, whether I was standing on it or had it propped up. The Dr. gave me several cortisone shots at the base of the toe, none of which helped. He refused to prescribe anything stronger than OTC Tylenol. I developed an infected ingrown nail in the toe next to it - - a toe that had never bothered me before. He cut the right side of the nail away, which stopped the pain in that toe.

    I will try to describe the pain I feel in the toe that was fused. When I walk, it is as though I am walking on bare bone where the joint used to be, as though the full weight of my body is pressing down where the joint used to be - - - TRYING TO BEND WHERE IT CANNOT. There is no padding where my toe contacts the ground. The toes around it "try" to compensate by curling under. My gait has been impaired and I now have severe joint damage in my knee. Sometimes I feel reconciled to living with this daily pain, sometimes I am angry, even occasionally in despair. There must be something that can be done. I know that amputation sounds drastic, and maybe it wouldn't help, but I would love to go shopping or walk around the block again without being in pain.
     
  5. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***********************************************************
    I am not disputing the fact that you have pain, but I would suggest that much of your analysis of the cause of your problems following the surgery may be off the mark. I would consider it more likely that the pains you are suffering might be more associated with the neuroma removal rather than anything that was done to the toes or the use of a tourniquet during the procedure. It could even be more likely associated with your own bumping of the foot shortly after the surgery, but not likely the busted suture or slight wound dehiscence. Lesser toes do not have a great deal of function in either weight-bearing or ambulation. I wouldn't rush into considering an amputation of a toe before determining whether the pains are instead mediated by nerve pathology proximal to the toe.
     
    Last edited: Sep 7, 2009
  6. Unregistered

    Unregistered Guest

    Okay, given all that, where do I go to get an evaluation that will provide some real answers? I've wondered if there is anyone who does gait evaluations (specifically looking at the dynamics of the foot) to see if I can change the way I am walking? I've tried all sorts of inserts with minimal relief, seen three Dr.s and have no answers. If you could recommend anyone, who would it be?

    Since this was the fifth neuroma I had removed I'm familiar with the sort of numbness that comes with it. This is different, and not the main problem. The main problem is the long toe that "wants" to bend when I walk on it. If you try to bend the middle joint of a finger backward, that's what it feels like.

    Is there anyone in the country who has successfully "undone" a fused toe?
     
  7. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***********************************************************
    Undoing a fused toe is easy. It simply requires bone removal, with or without an implant. The question is . . will it do what you think it will for you? You have supposed that changing the way your walk or unduing a fusion will effect a cure, but REAL, not supposed diagnosis is the key to effective treatment, and I tell you again that you are focused on perceived causes which may or may not be the problem. In the end, not all problems can be diagnosed, not all diagnosed problems can be fixed and not all doctors are equally skilled at either.
     
  8. Unregistered

    Unregistered Guest

    I get what you are saying. I am speculating because I'm trying to figure out how to cope with pain I can do nothing about. If someone tells me definitively THERE IS NOTHING THAT CAN BE DONE TO RELIEVE YOUR PAIN, so be it. But so far I haven't heard that. I've heard that figuring out what is going on and doing something about it is not an exact science and you need someone very skilled to help you make a treatment (or non-treatment) decision. I need to know where to look for such a person. Where would I go to find someone with the skills needed to help me make this determination - - - who will do more than give my foot a cursory glance and say I don't know. There's got to be someone who can at least give me a serious exam and advise me based on what they know, not what they don't know.
     
  9. FootDoc

    FootDoc New Member

    Medicine is at least as much art as science. Fixing people is not like fixing machinery, where, if all else fails, and sometimes even before that, the part or module is replaced, even without a real diagnosis, and if that doesn't do it you try another part or module. There is no sure-fire way of finding the particular doctor who will solve any particular problem, but the best doctors tend to concentrate themselves in quality institutions such as major university-affiliated teaching hospitals. That would probably be the best place to start.
     
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