29 months (August 2013)

Saga continues....

I went to China in June and three days after getting back, I started getting nauseas and having terrible abdomen and groin pain.  After two trips to urgent care, two rides in ambulance, three ER visits, one CT scan, three ultrasounds, and one MRI, we still don't have answers.  The doctor isn't sure if it is the spreading of the CRPS or a nerve injury from sitting crammed in a plane for 14 hours.  I'm now on the fentanyl patch with norco for break through. The pain had localized to my groin and privates.  Feels like they are constantly being squeezed.  Miserable.  Getting a nerve block next week.  Hope it helps.  Doc really wants me to consider having a neuro stimulator implanted but I'm not sold.  Definitely mixed results to read about.  There is a new treatment that has been very successful.  It involves high doses of a ketamine injection for a few days.  Going to research.

On a side note, I am now taking Gralise instead of Gabapentin (neurontin).  It is incredibly helpful.  It is extended release version and is amazing.  Only down side is that most insurance won't cover it.

This whole episode is now impacting my ability to work.  Haven't put in a full day since June.  Scared to think about what the future may hold.

21 Months (January 14)

Had a few comments posted so I think it's time for an update.

Since my last post, I've moved half way across the country for a job.  It is awesome except for my stupid foot. I've developed hammer toes and am working on stretching the tendons again.  I will start pt soon. The pain comes and goes, no big change there. I do live in a mountainess area and it is pretty depressing not being able to fully enjoy. Hikes are limited and skiing is out of the question. I am still on the same meds and my norco dose is up to 5 a day. I've also been prescribed clonidine for breakthrough relief but it doesn't really do anything. My new pain doc had me try Nucynta. It's the first new opioid developed in a long time. Supposed to work as a regular opioid and have the same effect as tramadol. Some people love it. Didn't do much for me and gave me anxiety. I was on the 100 mg pills.

My doc warned me a while back that I may develop back problems due to limping for so long.  Well, that has happened. I have a pinched nerve in my neck that sends electric shocks down my arm and into my face when really bad. I can barely sleep because my back hurts so bad. I'm getting an MRI of my neck soon.

The really scary news is that when the doc administered the versed to knock me out for my most recent injection, he had to give me 12 mg. the normal dose is 2 mg! That means that if I ever have an injury and need pain relief, it will be very difficult to achieve it. Not good.

Lastly, I've had flare ups since I've been in Colorado. I've gone to the ER and they completely blew me off. I guess that's the difference between a hospital in a medium size town and a major metro area.   They just assume here that you're a junky. Even though I brought in all my files. Terrible and scary.

16 Months (August 21st)

Quite a bit has happened since my last post.  The pain in my ankle continued to escalate and I ended up in the emergency room in June.  The pain meds were not getting it done and I woke up at around 4 in the morning and couldn't take it any more.  The hospital did the usual tests and had to shoot me up with three rounds of dilauded and put me on oxy.  Fortunately, I had an appointment with my surgeon scheduled for the next day.  When I went in to see him, he said that he can't see any reason for the continued pain and recommended that I see a pain specialist.  He wanted tor rule out RSD.  I went to the pain clinic the next week and discussed my symptoms with the doctor.  At this point, I could barely walk around the house without significant discomfort.  Extended walks were completely out of the question.  The ache in my heel and ankle were non-stop and worse after activity.  The doc suggested an injection in my back to calm the sympathetic nerve.  He also put me on the gabapentin, an anti-depressant (effexor), and 4 norco per day.  The procedure for the injection was interesting.  I went in and they put an iv in my arm.  Then they gave me something for pain and to calm me down.  The next thing I know, I'm in the recovery room.  I guess they don't really knock you out put just make you really loopy and amnesiac.  The pain in my ankle/foot got worse over the next 6 days and was to the point where I could barely get out of bed.  I was taking 2 norco at at time every four hours and was miserable.  Then, out of nowhere, I woke up on the 7th day and the pain was reduced about 80%.  It was incredible!

I continued on the meds throughout June and July.  For the most part, my foot would ache a little when not doing anything and get quite sore when I walked a lot.  What is strange is that the ends of my toes became very sensitive to walking and would really hurt if I was on a tile floor.  The same thing was happening with the bottom of my foot on the lateral side.  I went back to the pain clinic around August 6th and the doc said he does believe that I have mild RSD (I can't imagine what major would be like!) and wants to continue with injections and treatment.  I did explain that the 4 norco a day are not enough if I am active.  He then switched me over to extended release ms contin.  Apparently, this is morphine.  Unfortunately, whenever I got morphine in the hospital in the past, it hasn't worked. It just makes me warm.  So, I am now on the ms contin, gabapentin, and effexor.  I really do not like the ms contin as it is not very effective for me and it makes me really out of it.  I honestly don't know if I could maintain a difficult job while on this.  I am constantly searching for the right words and my memory is affected.  I am going to request that they take me off of it immediately.  I really don't like it.

I'm scheduled to see the pain specialist again in September as well as my surgeon for an update.

13 Months (May 2)

Has been a while since I've posted.  Things are good and bad.  I've definitely made progress regarding the amount of weight I can put on my foot.  However, I'm having a lot of pain in my achilles, heel, and bottom of my foot.  The doctors office has put me on Gabapentin.  They think it may help calm the nerves that are upset.  I started taking it yesterday (1 dose), have taken 2 today, and will take 3 tomorrow.  No benefit yet.  I got a script for 40 Norco Tuesday last week and am down to 3 already.  The docs office doesn't want to give me more.  I'm really hoping my foot calms down otherwise I'll be calling them on Friday and telling them I need more.  Not good.

1 Year + (April 16)

Not much new to report.  Still have burning on the back and side of my foot if any pressure is on it.  Guess the bone is still healing.  If I try to put too much weight on my leg, I still get the weird pain in my achilles.  I have been spending a little more time with the boot off and the front of my ankle really aches.  Hope that gets better soon.  I have been getting quite a bit of spotting in my sock.  Just little blood spots every now an then.  I've started covering one area with a banage with Neosporin on it just to make sure it doesn't get infected.  Here's a pic....

1 Year + (April 10)

Okay, this is scary. As noted earlier, I saw the MA to get my stitches out 2 weeks post op. She told me I could transition to FWB between 2nd and 3rd week, sleep with boot off at night, and that it wouldn't be a problem to fly for my interview next week (5 weeks post op). I just spoke with the surgical nurse to confirm if I could sleep with my boot off. She checked with the doc and:

a) I am only allowed to pwb since the bone is still healing.
b) I can not sleep with my boot off and need to keep my leg elevated.
c) I am not allowed to fly or have my leg down for extended periods of time.

No wonder I'm having so much pain and my leg is swelling so much. Now I need to find an alternate way to get some place 12 hours distant by car in order to interview.

1 Year + (April 6)

I was making great progress towards walking without the crutches until yesterday afternoon.  I was using only one crutch and putting nearly all of my weight on my foot when I felt a horrible pull in the achilles.  It dulled down but kept happening every time I would put any weight on my foot.  I ended up not putting much weight on it at all today and am hoping it is improved by tomorrow.  I am getting a burning pain in my heel that is similar to what I felt after the original osteotomy.  It comes and goes and seems to depend on the position of my foot.  I did just look and I do have bruising on the back medial portion so that may have something to do with it.  I'm still averaging about two doses of meds per day.  

Here are some updated pictures.