A Reader Chooses the More Invasive Surgery for Her Plantar Fasciitis

by Katherine Poor

          My feet started bothering me in late August 2003. Years ago I was a runner. I enjoyed it and really have no idea why I stopped. My coworker is a marathon runner. We talked about getting together during lunch and running. She suggested that I ease into by walking first. I agreed and the following week we met in the locker room to begin. We walked 3 days that first week.

          The next week I got out of bed and noticed how sore both my feet were. By the time I was out of    the shower the pain was gone and I forgot about it. She and I continued to walk 3 days a week. In September my husband and I went to the Carolinas for a weeks vacation on the beach. We swam  and played in the sand and surf. All the while the heel of my left foot was killing me.

          When we returned I made an appointment to see my primary care physician. He diagnosed plantar fascitis. I had not idea what that was. I went another week and then looked up a podiatrist. Thankfully my insurance is set up so that I don't need a referral to see a specialist. X-rays were taken of both feet. Sure enough, there they were, heel spurs in both feet. Fortunately only the left foot was symptomatic.

          My doctor is one who takes a conservative approach to treating heel spurs. First I was fitted with orthodics. They felt wonderful and my right foot responded beautifully. My left foot? Not so much. The doctor followed up with taping the left foot. We did that twice, 4 days each time. I wasn't able to take anti-inflammatory medications because they can trigger my asthma. I was restricted from gardening, hiking, climbing ladders anything that would over stress the foot. The tape did no good. Next idea: Rest the foot. No appreciable activity at all for a month.

          After the month's rest, there was no discernable change aside from  increased pain. We were now at the six months mark. The doctor opted for the Final Act Before Surgery: I was given a cortisone injection into the heel. I have a terrible fear of needles, nearly paralyzing. The shot didn't work and caused so much trauma that we decided NOT to do that again. The last thing to do was wait. My doctor wouldn't consider surgery until nine months into treatment. We set an appointment for 3 months out and I was sent home to take it easy. On June 4, 2004 I went back to the podiatrist, still in pain from the time I got up in the morning until I went to bed at night.

          My husband and I had already talked about surgery and what it would mean. We were both tired of not being able to hike, hunt or geocache (our new favorite sport, hiking for geeks!). I was ready to schedule the surgery before the doctor entered the exam room. Sure enough that is where we were, and I didn't want to put it off. I had to be back on my feet in time for hunting season in the fall.

          The doctor and I discussed the options as he described what each would entail. He preferred to do a single 2-inch incision on the inside of the heel. It was a more invasive procedure, but the visibility would be  greater. I was sent home with an air cast that I would have to wear for 4-6 weeks after surgery. Stylin'!

          June 16, 2004, my 38th birthday: I arrived at the hospital at 7:30 am. I was scheduled for 9:45 a.m.. It went off without a hitch. I was in the recovery room by 10:30 a.m. Before they would release me I had to eat something, drink something and use the restroom. By 10:45 that had all been done and I was ready to be wheeled out of there. They brought me my clothes, which I impatiently donned. The doctor sat with me for a few minutes, explaining what I could and couldn't do. I could get up to go to the bathroom. I  couldn't do anything else. That's right, stay down, foot propped up, icing it 20 minutes every hour for the first 2-3 days. I could hardly wait.

          My husband loaded me in the truck and we were home by 12:30.

          Day one: my foot was numb for the entire day. I iced as instructed and relaxed, letting the anesthesia wear off. There was a little oozing from  the dressing, but that was to be expected. My husband and I switched sides on the bed so that I would have a straight shot to the bathroom and my foot would be on the outside of the bed. As nice as that sounds, neither one of us could sleep. We tried it for 2 nights and then gave up, going back to our regular sides.

          Day two: the top of my foot was coming to life. Why was the top of my foot bothering me? The doctor told me that if my foot started throbbing I should first try loosening the ace bandage and rewrapping the foot. It would help with the pain. I am not fond of painkillers so I was only taking ½ a Vicodin at a time. It kept the pain away for the most part.

          First week: More of the same, I was feeling pretty good and of course I was on my feet far more than I should have been.

          June 24: First post-op appointment. I was royally chewed out for being up  as much as I had been. Since I can't take anti-inflammatory meds I was  swelling a lot more than was normal and I was in a lot of pain. I got grounded! Then again, I deserved it!

          The dressing was changed and I was able to see the incision,
It was huge! I still had to keep the foot dry. We have a claw foot tub, climbing inand out of that to bathe was not fun. I had a board straddling the edges so that I could prop the foot up on that and lie down in the water. Thankfully I am flexible. I was able to bend forward to wash my face. Baby wipes make excellent wash clothes for areas that can't get wet. I can't stand going a day without washing. This was difficult.

          Week three: I went for my 2nd follow-up appointment. The dressing was changed again. Silver nitrate was applied to the incision, to cauterize the wound and I got the go ahead to get my foot wet. Yay! A real bath!!!

          July 5, 2004: I went back to work, part time to start, moving to full-time the next week. I was allowed to be ambulatory 5 minutes every hour. I had  to be very careful with bathroom breaks and going to the lunchroom. Unfortunately the bathroom was a bit of a distance to hike to.

          Week six: I took the air cast off when I got home from work and wore  regular shoes for a couple of hours. My feet were sore by bedtime, but hey, I was wearing my pink & white checkered skull Vans again. Ahhhhh! Oh! Ouch!

          My recovery seemed slow but steady. I got relief when I sat for a bit with my foot propped up. I'd started doing mat Pilates as a way to combat the immobility and boredom around Week 3, and it helped my mental state quite bit.

          August 1, 2004: The first day I went all day without wearing my air cast! I noticed that I was compensating for the tenderness by walking on the  outside of the foot, so I started getting into the habit of reminding myself to flatten the foot and use the entire surface. I got around pretty well for being out of the Big Boot full-time.

          August 3, 2004: I had a doctor's appointment today. He was pleased to see how I was doing. I am wearing shoes full time now. I am tender footed in the morning and sore at bedtime but during the day I am able to walk around relatively pain free. I am very happy and I don't have to see the doctor for another six months. YAY!

NOTE: Katherine has promised to provide updates on her recovery.  She has also offered to answer quesions, so e-mail me and I will pass your questions along to her.

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