Thursday, July 26, 2012

Morton's Neuroma Surgery Follow Up Report

Well, it has been 9 months since I had that nasty little bugger of a neuroma cut out from between my third and fourth metatarsal heads on my left foot.  Let's just say that if I was a horse, I would have been shot by now.

And here is how it goes!  The surgery had gone great and 3 months later I was in Arizona at the SSAZ riding without pain.  I rode my SS for 5 straight days, 25+ hours, and who knows how many miles.  Only on the last day did my feet start to bother me a little bit.  I experienced some mild numbness and tingling across the balls of my feet, save for the surgery site.  There I experienced nothing at all.

Everything was going great, I was winning the spring Chainbuster 6 hour series on my single speed.  Then in May (7 months post op), my feet started taking a turn for the worse.  After the Chainbuster race at Winder, I noticed the tingling, burning, and painful sensations returning across both feet.  I also noticed that the scar tissue from the surgery appeared to be getting thicker and more tender to the touch.  It became uncomfortable walking barefoot, especially on my left foot.  Where the scar was, every step felt like I had a large rock under my foot.

At work, I was miserable, having to stand 10 hours a day.  I did my best to sit every moment I could, but we are a very busy practice and that was difficult to do.  And then, to make matters worse, I began to have electrical jolts of pain just proximal to the surgery site.  That did not feel good at all!  I was having to soak my feet in ice baths 2-3 times a day to make the pain and electrical stimulation go away.

The funny thing, however, is that my feet hardly bothered me at all while I was on the bike.  I know that the long hours in the saddle had to be affecting them, but to me the days at work made them hurt 10 times as much.

I was apprehensive about the Pisgah 111 and afraid that I would have to DNF, given the amount of hike a biking. I started out conservatively, just waiting for the pain to appear.  Funny thing, that day, my feet were great!  After about an hour I was able to pick up the pace and forget my feet.  Only towards the end on that last Black Mountain hike a bike section, did they start to bother me.

In between the Pisgah 111 and Karl's Kaleidoscope, my feet went back to their former painful, burning, tingly selves.  After Karl's Kaleidoscope, I went back to see my podiatrist.  I have had a history of cheloid formation.  This is basically a scar gone awry, laying down granulation tissue instead of maturing into a nice healthy small scar.  Cheloids can be painful and even entrap the end of the severed nerve, causing the nerve to fire.  It was either that or I was developing a neuroma at the site where the nerve was cut.

After discussing this with my doctor, he ultrasounded the surgery site looking for evidence of a new neuroma.  After not seeing one, we decided to inject the scar with dexamethasone, a type of steroid.  Within 3 days, the electrical jolts had stopped and I had less tingling, burning sensations when I walked.  Whoo hoo!  Small victory.  However, I was still experiencing numbness across the entire balls of my feet.

Since then, I have had a second injection and am still seeing improvements. The scar is beginning to soften and decrease in size.   I am now able to walk barefoot some and the days spent at work are not as excruciating.  I have also made some other adjustments which are helping as well.  Although it is killing me, I have not single speeded since May 5.  I am sure that mashing the pedals aggravates those other neuromas that I do have.  I have taken up swimming to replace those easy recovery rides.  And I have switched from wearing Keen's to Chaco's.  The Chaco's support my arch better so that more of my foot is taking the impact.

Next week I will be going for a second opinion to a foot surgeon (who is also an athlete) on this issue.  I am hoping that she has a miracle cure ... other than a bullet!