Saturday, June 15, 2013

The Calm Before the Storm-Amputating my bad TOE with Lupus

The toe must go!

I finally found a surgeon (orthopedic) to go in and obliterate my neuroma under the 4th toe right foot. He suspects its a stump neuroma with a damaged/entrapped nerve. I have given him permission to cut the nerve, remove the nerve and if necessary amputate the toe!

What do I need that toe for anyway? It’s the thorn in my side, the cause of a massive amount of pain (it comes in flares). I’m the lion with the thorn and he is going to remove the thorn. I am so so thrilled! Yipppppeeeeeeee!

The bad side: Once again I’m off my lupus meds, no cellcept, no meloxicam or plaquenil or of course prednisone. Ouch. Here comes the joint and muscle pain. The afternoon low grade fevers, the queasiness. It’s worth it though.

I know many people with lupus have nerve problems. Here’s some info about neuromas, specifically Morton’s neuroma which is usually located between the 3rd and 4th digit on toes. If you have one-you KNOW how exquisite the pain can get. It’s a thousand papercuts, a sharp knife slice over and over.

From Mayo.com:
Morton’s neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. Morton’s neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock.

Morton’s neuroma involves a thickening of the tissue around one of the nerves leading to your toes. This can cause a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb.
Typically, there’s no outward sign of this condition, such as a lump. Instead, you may experience the following symptoms:

A feeling as if you’re standing on a pebble in your shoe
A burning pain in the ball of your foot that may radiate into your toes
Tingling or numbness in your toes
When to see a doctor
It’s best not to ignore any foot pain that lasts longer than a few days. See your doctor if you experience a burning pain in the ball of your foot that’s not improving, despite changing your footwear and modifying activities that may cause stress to your foot.

Morton’s neuroma seems to occur in response to irritation, pressure or injury to one of the nerves that lead to your toes.

Treatment depends on the severity of your symptoms. Your doctor will likely recommend trying conservative approaches first.

Therapy
Arch supports and foot pads fit inside your shoe and help reduce pressure on the nerve. These can be purchased over-the-counter, or your doctor may prescribe a custom-made, individually designed shoe insert — molded to fit the exact contours of your foot.

Surgical and other procedures
If conservative treatments haven’t helped, your doctor might suggest:
Injections. Some people are helped by the injection of steroids into the painful area.
Decompression surgery. In some cases, surgeons can relieve the pressure on the nerve by cutting nearby structures, such as the ligament that binds together some of the bones in the front of the foot.
Removal of the nerve. Surgical removal of the growth may be necessary if other treatments fail to provide pain relief. Although surgery is usually successful, the procedure can result in permanent numbness in the affected toes.

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