Tuesday, February 21, 2012

Reflex Sympathetic Dystrophy?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.
Ask your medical question here. : MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.

RSD or intraoperative back injury?
Three years ago I had the great toe joint in one foot replaced with a titanium implant and a Morton's neuroma removed at the same time from that foot. There was an unusual amount of post-op swelling even with keeping the foot elevated at all times, and it continued to have odd vascular changes for years, turning purplish-black with a few seconds of standing for the first two years. At the same time, the foot had a distinct sensation of being burned and crushed simultaneously. That has diminished only slightly. I also had severely painful muscle spasms from my lower back, with most of the muscles in the pelvic floor and the whole leg remaining in spasm. After PT was ineffective, I was referred to a pain management MD who diagnosed RSD. Now, the limb is noticeably smaller than the other and continues mild constant spasms and pain that tracks the path of the sciatic nerve, originating in my lower back.
I have Ehler's-Danlos and it occurred to me the other day that I have never had surgery but that being moved off the table while sedated caused an injury that took quite some time to heal. The astounding and unremitting pain after the foot surgery started the day of the surgery, not later as you might expect from RSD. Is it possible that being dragged off the OR chair harmed nerves in my lower back, and that I  might have something that could be helped? Would an MRI show damage that was unseen on previous CT?


Gender: Female
How tall are you (feet and inches)?: 5'11
What is your weight in pounds?: 160
How old are you?: 52
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Abdominal Pain
Musculoskeletal Pain
Neurological
Describe associated symptoms not listed above: Increased pain down legs from back immediately before and after bowel movements.
Swelling in foot, redness and warmth at joint replacement site

What have you done so far to remedy this condition? Please include tests and relevant studies here.
: CT: lumbar facet disease, SI joint abnormalities
MS ruled out by MRI brain
Lyrica prescribed, helped for two weeks, caused large weight gain, stopped taking.
NSAIDs, stopped with onset of collagenous colitis
Neurontin and Xanaflex at bedtime
Magnesium malate and calcium supplements

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Hashimoto's, now well controlled with Synthroid
Ehler's-Danlos with vascular and skeletal effects, especially bruising, low blood pressure, easily dislocated shoulders, knees, and hip joints, eye deformities.
Collagenous colitis.


Surgery: Lasik eye surgery, adenoids and tonsils as adult, benign breast tumors, benign tumors of the Fallopian tubes, Obdurator space hernia and femoral space hernia repairs, lap chole, vag hyst, rectocele and cystocele repairs, bone spur removal hallux joints.

Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cardiac Disease
History of Back Pain
Please list any medication allergies that you have : : sulfa: hives, throat swelling
Please list any medications you are currently taking (and dosage if known) :: Neurontin 600 mg hs
Xanaflex 4mg hs
When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Daily
HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within the next few days
Tell us your top three things you wish to be addressed in our response.: Should I ask for an MRI of my back and/or foot?
Should I see a neurosurgeon or an ortho guy about the pain that starts in my back, rackets around in my guts, and shoots down my leg?
Is it possible that an intra-op back injury could mimic RSD?

Saturday, February 18, 2012

Appendicitis?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Ask your medical question here. : MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.


I had my appendix out a month ago. The surgeon said it may not have been appendicitis, that the CT looked like it bu that when he got the appendix he wasn't sure. In follow up the surgeon said the pathologist wasn't sure either. I have since had an episode or two of pain that is similar to the initial. What should I do? What could this be?
Gender: Male
How tall are you (feet and inches)?: 5' 6''
What is your weight in pounds?: 165
How old are you?: 28
How long has this been going on?: More than a month
Check all symptoms you are currently experiencing: Diarrhea
Describe associated symptoms not listed above: none
What have you done so far to remedy this condition? Please include tests and relevant studies here.
: only what is above. I do not have a primary care physician but I do have insurance.
Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): None except for appendix surgery.
Check all conditions present in your immediate family... : None of these
Please list any medication allergies that you have : : none
Please list any medications you are currently taking (and dosage if known) :: multivitamin
When was your last menstrual cycle?: Now
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within the next few days
So that we can serve you best, please try to tell us your top three things you wish to be addressed in our response.

If this wasn't my appendix what might it be?
Did I need the surgery?
What do I do now?

Thursday, February 16, 2012

Plantar Fasciitis and Heel Spur


I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.
 
I have been diagnosed, through an mri, with plantar faciitis. I also have what my Dr says is a large heel spur in the same foot. I have been having the heel pain all day for about 3 or 4 months now. It always gets worse as the day goes on. I work in retail and am on my feet 9 - 12 hrs a day. I have received a cortisone shot which did not work. I am now in physical therapy. My physical therapist said it would be a good idea to take a few weeks off from work while I am in physical therapy. My Dr did not suggest this. Would it help to do this? Is there any long term issues I could have if I do not rest it properly? There seems to be a lot of different opinions about treatment for this.
 
 
Gender: Female
How tall are you (feet and inches)?: 5'3"
What is your weight in pounds?: 125
How old are you?: 33
How long has this been going on?: More than a month
Check all symptoms you are currently experiencing:
None of these

What have you done so far to remedy this condition? Please include tests and relevant studies here.
: Mri, icing, stretching, physical therapy, heel lifts.    Mri report said mild posterior plantar faciitis and mild posterior marrow edema consistant with plantar faciitis

Check all conditions present in your immediate family... :
None of these
Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: Lexapro 20mg per day
When was your last menstrual cycle?: 2 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within the next few days

So that we can serve you best, please try to tell us your top three things you wish to be addressed.

: Rest for plantar faciitis?, long term consiquences if not treated properly, any treatment suggestions.
____________________________________________
 
Thanks for your question. Some quick initial thoughts.... If the doctor treating you is not an Orthopedist or Podiatrist you may want to get in to see either of these types of doctors. My concern is whether the heel spur is an issue for you. As to the taking time of work that would definitely help but may not be possible for you. Custom fit orthotics may be of great benefit to you and if this has not been mentioned or suggested then I'm not sure why it hasn't. I'm sure my colleagues will weigh in shortly, in the meantime, take a look at this link HERE for some good information regarding plantar fasciitis. Thank you so much for your question and I hope you get well soon. 
 
MDSTAT Doc 1

Thursday, February 2, 2012

Achilles Tendon Problem in a Child

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.
My son will be 7 in May, and ever since he could walk he always walked on his Tip toes. I always thought it was normal and he would grow out of it, but his Ped. was concerned so we saw an Ortho surgeon yesterday. My son does complain that his feet/legs hurt or get tired very easily...however, the surgeon said all kids complain about that...and that it's not related to the toe walking. Ortho said he has contracture of both achilles tendons...and that because he is almost 7, that they are "fixed" in that position and other methods will not correct it. He basically said that the toe walking will not affect him physically through out his life, other than just walking on his toes. He said the surgery is considered "cosmetic" and it will be done just to make him walk heel to toe, and it's up to us if we want the surgery or not. I do want the surgery, because I am so afraid that he will be made fun of by other kids through out his life. I don't want anything to make him feel "different" than others. What I need to know is if you think the pain/tiredness in his legs/feet are related to the toe walking. I think it is, but the ortho said no. And do you really think he WILL toe walk for the rest of his life without the surgery? And will he be able to participate in sports? I don't know what to do, please help!


HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within 8 hours
Will he toe walk for the rest of his life?
Pain/tiredness related to toe walking?
Able to play sports in the future?
Gender: Male
How tall are you (feet and inches)?: 4'1
What is your weight in pounds?: 49
How old are you?: 6.5
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Musculoskeletal Pain
Describe associated symptoms not listed above: Pain/tiredness in both legs/feet
Toe walking, running, and standing.
What have you done so far to remedy this condition? Please include tests and relevant studies here.
: Physical examination by Ped. and Ortho specialist
Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cancer
Cardiac Disease
Diabetes
History of Back Pain
Psychiatric Disorders
Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: Ritalin ER 18mg for ADHD
When was your last menstrual cycle?: I'm a man, baby!
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Never