History of foot

June '94

bulletFirst big attack: middle of the night, woke up with burning in arch of left foot.
bulletBurning lasted 4 days. Soreness lasted 2 weeks.
bulletSaw ER doctor and podiatrist
bulletDiagnosis: plantar fascitis

 

Sometime '96

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Big attack: middle of the night, woke up with burning in arch of left foot.

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Burning lasted 4 days.

 

Sometime '98

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Big attack: middle of the night, woke up with burning in arch of left foot.

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Burning lasted 4 days. Pins and needles in big toe and arch.

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Lower leg became very swollen.

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Dr. Cabales (internist) put me in hospital for tests for blood clot; results negative. Did blood work looking for other causes. He prescribed Apap/Codeine 300-30mg, 4Xday.

 

November '98 - March '99

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Little attacks every night: Middle of the night, woke up with burning in arch of left foot. Sometimes, the big toe would be numb. Would walk for 20 minutes, and then could sleep in a chair with the foot on the ground.

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Had a few more attacks where lower leg would swell quite a bit; swelling would last 2-3 days.

 

March '99

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Diagnosis: tarsal tunnel syndrome (confirmed by EMG).

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Did blood work looking for other causes.

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Doctor: Sheldon Lin performed tarsal tunnel decompression surgery; didn't help. He prescribed Elavil; I didn't like side-effects of Elavil (25mg, then 10mg).  Percoset; Percoset didn't seem to help. Vioxx (25mg); didn't help. Roxicet (5-325mg, every 4 hours)

 

April '99 - May '01

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Most months have big attacks with swelling.

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Numbness in big toe after some big attacks (March '00)

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Most months have 2 weeks of small attacks.

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Small attacks normally begin on the first night of my period OR on the last night of my period.

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Walking during small attacks helps with pain.

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Use Demerol (50mg every 4 hours) with big attacks for 36 hours.

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When sitting, cannot have left foot on ground or get electric shocks or pins/needles feeling in foot.

 

July '01

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 Small attacks every night. Biking helps. Cold water baths with ice helps.

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Walking doesn't help anymore.

 

August '01:

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Saw Geraci (neurologist); he performed EMG; said there was no nerve compression in the tarsal area. He ordered MRIs of the lumbar (8/18/01) and pelvis, which came back normal. He prescribed MS Contin (15 mg first, then 30 mg). He sent me to a pain management clinic; he thinks it is RSD.

 

Sept 18 '01 (description of pain in mid-Sept '01)

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7 out of 8 nights, wake up 1/2 hour after go to bed or napping

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pain is normally burning, sometimes itching

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walking helps sometimes; biking almost always helps

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very hot or very cold foot baths help

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pain last 1-4 hours

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have swelling at ankle

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during the day have moderate pain; burning and a heavy numbness that is difficult to walk on. socks and most shoes bother me; have hypersensitivity

 

Sept 26 '01

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got RF nerve block from Thomas; no change. (Gary Thomas at the Cabrini Pain Management Center; pain management doctor)

 

Oct 12 '01

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Thomas started me on neurotin; wants me to get to at least  300 mg, 300mg, 600mg per day

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He gave a steroid injection in medial ankle at mid scar (triamuinolore and bupivicaine). the steroid injection caused a big attack within 5 hours. The swelling was worse than i ever had; gained over an 1" around the calf; it went down within 24 hours

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The pain was very very bad; biking hurt, water baths didn't help; took 1200 mg MS Contin, which seemed to help after 3 hours - the calf muscle and tendons tensed up; i needed a muscle relaxant to help keep the muscle relaxed; i was on crutches for 5 days do to muscle pain

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Had very bad lower back pain for 7 days

 

Oct 26 '01

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current nerve pain

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NO burning at the ankle area

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frequent electric shocks, numbness over entire foot bottom, mottleness over entire foot bottom

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sensitivity to touch increases; esp. bad on bottom of toes and side of foot by little toe.

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current other limited toe mobility; can only flex toes in a limited manner; cannot point toes at all, or spread toes. when I try to point, the toes have no resistance.

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Pain in foot while peeing and coughing

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Saw pain management doctor. he prescribed an anti-inflammatory for the muscle/tendon (diclofenac sod / voltaren, 75mg) (this bothers my stomach; sour stomach). he suggested creative movement for the toes to help heal the nerve. he prescribed vitamins to help heal the nerves; should take 6 months. multi-vitamin lecithin: 1000mg, 2X day. flax seed or primrose oil: one capsule, 2X day. GNC, Parmassure, Neurosyn. he seemed surprised with the toe problems.

 

Nov 1 - Nov 30 '01

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Am using crutches; too much muscle pain and hypersensitity when walking

 

Nov 8 '01

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Geraci repeated lumbar and pelvic MRIs repeated (Oct 30 01); they came back normal.

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Saw Geraci: during his exam, he said that i have weak hips. he prescribed Ultracet (1 table 2 X day); it seemed to help with achy feeling

 

Nov 23 '01

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Off the neurotin completely; didn't like side effects.

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Had spinal MRI; no contrast was used.

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Geraci wanted to rule out a dural AV fistula.

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Results were normal; on 11/30, Geraci reported that there was a little thickening of the spinal cord that might occur with fistulas.

 

Dec 17 '01

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Saw OB/gyn (Dr. Thomas at Mt. Sinia); he saw no evidence of endometriosis.

 

Dec 20

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Current description

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Calf very tight; hurts to touch

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Quite a bit of muscle atrophy in calf

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Have severe tendon pain on left leg (outside of ankle, and outside of knee) going up back of thigh

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Cannot sit still, started muscle relaxant (baclofen again; 60 mg/day)

 

Dec 23

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Shooting pain started at tail-bone area and goes down back of thigh

 

Dec 27

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Saw Dr. Weinberger at Columbia pain management center

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He prescribed an opioid (hydromorphone; 2mg as needed): (having problems with constipation)

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An anti-depressant (nortriptyline; 10 mg at bedtime).

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An increase in the muscle relaxant; 30 mg 3 X day

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His examine showed reflexes at ankle not working

 

Dec 28, 31

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Current description

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Am not sleeping more than 2 hours/night

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Still cannot sit still; mornings and evening are worst

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Muscle between calf and ankle cramping a lot

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Either the peronius brevis or the flexor hallucis longus)

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Stopped taking muscle relaxant; calf is better

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My semimembrranous is sore; this is one of the hamstring muscles, starting at the top of the knee.

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My piriformis muscle is sore; this is one of the hips; the pain starts around the tail bone and goes 5 inches or so.

 

Jan 14 2002

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Increased nortriptyline to 20 mg at bedtime; started Ultracet again

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Am sleeping better and some of the achiness is gone; can mostly sit still

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Tom thinks he see atrophy at hamstring area

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Am having problems pointing the foot, both with the toes and ankle stopped taking extra vitamins

 

Jan 24 2002

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Increased nortriptyline to 30 mg; still on Ultracet

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Having problems clipping in pedals; when biking, left leg isn't useful due to inability to lock ankle.

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Can sit still half the time.

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Current description

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Tendon-like pain behind knee on outside of leg and on ankle (an hour/day)

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Calf, hamstring and piriformis muscles are sore; heat helps once every 5 days, have shooting pain from tail bone down back of leg

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The numbness on bottom of foot at big toe is coming back; electric shocks are back.

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Get goose-bumps in patches on entire left leg when i bike.

 

Jan 29, 30, 31 (full moon)

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Burning pain in middle of night (small attack; first since Oct.)

 

Feb 4

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Saw Adams (neurologist at Columbia); he found a "mass" on the hamstring. He ordered blood work, MRIs of the calf, thigh, and butt, and another EMG.

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He prescribed trileptal to help with the shooting pain; got rash

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Saw Weinberger (pain doctor); he discovered that my left adductors and abductors are much weaker than the right ones.

 

Feb 6

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Saw Fishman (Manhattan Physical Medicine and Rehabilitation) using EMC, he diagnosed piriformis syndrome; wants to give botox injection into muscle. Adams thinks we should wait until we see the results of the MRI.

 

Feb 12

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EMG - post tibial nerve is very weak to calf muscles; peneal nerve is fine; have slight radiculopy at S1-L5; hamstring muscles have denervation.

 

Feb 13

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Had knee xray; nothing abnormal
 

Feb 28

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Had MRIs of calf, thigh, butt done; everything is okay, but have 5x5x8 cm soft-tissue mass

 

March 13

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Saw Dr. Andrews (orthopedist at Columbia) to look at tumor.

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Andrews thinks it is a nerve tumor and that a neurosurgeon should do a biopsy.

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Current pain

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Pain in tumor area; achness

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Tight calf muscles; they feel too short tightness in hamstrings; feels like a band around the muscles.

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Pain when standing; some pain when walking.

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Skin color is poor on left lower leg; mottled or red; temp. is off in middle back of calf

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Electric shocks in foot, some burning in ankle

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Side of thigh (by knee) hurts after biking; feels very lumpy.

 

March 26

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See Guy McKhann (neurosurgeon at Columbia) would like to do incisional biopsy and remove the tumor if is it benign

 

March 30

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Got chest x-ray for surgery; nothing abnormal

 

April 4

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McKhann performed incisional biopsy of tumor; the results are an Ewing's sarcoma/PNET

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Since the biopsy: have shooting pains when straightening the leg or when putting weight on it. back on crutches. Have lost more sensory (back of the calf, by the knee)

Copyright 2003 The Shriver Family: Last modified: 01/06/04.