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Warren
USA
8 Posts |
 Posted - 07/01/2008 : 20:53:20
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I have had significant, chronic discomfort in the ball of my left foot for 3 1/2 years. I have seen five or six docs (orthopedic physicians and podiatrists), tried numerous pairs of orthotics, had steroid injections, tried taping, anti-inflammatories, etc. I also have tried to apply TMS techniques to my foot pain, which has helped me resolve many other pain syndromes in the past, including back pain, neck pain, and shoulder pain. Nothing has worked on my foot pain, including TMS. Trying to resolve this foot pain has obsessively dominated much of my thinking for years.
At wit's end and unclear as to what to do, I recently have tried to have the problem diagnosed medically. Towards that end, I had an MRI, CT scan, Bone scan and ultrasound. The results were osteoarthitis and possible avascular necrosis (bones are dead, similar to the hip injury Bo Jackson had) in the sesamoid bones on the bottom of my foot, nerve entrapment near my big toe and a partially torn flexor hallucis tendon in my left foot. I have received three primary possible diagnoses - nerve entrapment around big toe, sesamoid pathology and/or a partially torn FHL tendon.
Subsequent to these tests, I shared the results with two physicians steeped in TMS. First, I spoke to Dr. James Rochelle, an orthopedic physician who wrote a chapter in Sarno's Divided Mind on TMS. He DOES NOT believe my foot pain is related to TMS. He believes that I have structural damage in my foot. On the other hand, Dr. Marc Sopher, a family physician who also wrote a chapter in the Divided Mind and who has helped me before with TMS, said he DOES believe my foot pain is due solely TMS. I have spoken to Dr. Sopher about this foot pain at least four or five times, and he continues to believe my pain is due to TMS, even with these test results.
Now, I have no idea what to do. I am in the unenviable position of trying to decide who is right. Two highly respected surgeons are recommending surgery - one for the partially torn FHL tendon and another for nerve entrapment. Still another, of which I am less familiar, but who is an expert in sesamoid bone problems, suspects that I have avasccular necrosis of one or both sesamoids.
I'm faced with surgery or reemphasizing TMS, which has not worked so far for this foot problem, Honestly, given how long I have had this problem, the fact that I have not been able to resolve the pain using TMS in the past, and the fact that I do have structural changes, has led me to conclude that my foot pain is not due to TMS.
Any thoughts on this conundrum would be greatly appreciated.
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la_kevin
USA
351 Posts |
Posted - 07/02/2008 : 03:19:12
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Wish I could help. It is a true conundrum. Does it ever have periods of being pain free? Have you noticed a connection with the foot pain and emotions?
On the other hand, if you have a Doctor giving you a physical diagnosis, it would be wise to heed if he has gone as far as saying that you have real damage to a body part.
Maybe you should get a third opinion. Someone maybe like Schecter? Try and send him your case study and MRI's and ask him what he advises. Or choose all the TMS docs you can find and email them photos and charts. See that they think. When two theories oppose each other and create a conundrum, it's best to seek out 3 or 5.
We are supposed to rule out the physical before moving to TMS work. It would seem that Sopher is not allowing for the fact that it could not be TMS after all. But I don't know his reasons and I'm not a medical doctor.
Good luck anyways.
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"Life is what happens while you are busy making other plans"- John Lennon |
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armchairlinguist
USA
1397 Posts |
Posted - 07/02/2008 : 09:21:59
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Two things caught my eye about your post:
quote:
Trying to resolve this foot pain has obsessively dominated much of my thinking for years.
And
quote:
The results were osteoarthitis and possible avascular necrosis (bones are dead, similar to the hip injury Bo Jackson had) in the sesamoid bones on the bottom of my foot, nerve entrapment near my big toe and a partially torn flexor hallucis tendon in my left foot.
So you have been obsessed with the pain, which is consistent with TMS. There is a thread about this on the board just now, on whether obsession and fighting and continuing to care can actually perpetuate TMS.
And second, doctors are giving multiple diagnoses for your foot pain, which seems a little bit odd. I don't know how odd because I'm not a doctor, but it's typical of TMS pain to be given a variety of diagnoses, or uncertain diagnoses rather than one definite one. You also note that you have tried steroid injections and a variety of other things. Presumably they didn't work -- which seems odd (though again I don't know how odd) if the pain has a structural cause.
I'm not telling you I think your pain is TMS -- that is something you have to decide -- just telling you what stuck out at me from your post.
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What were you expecting? |
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Peg
USA
284 Posts |
Posted - 07/02/2008 : 18:57:01
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The same two things that ACL mentioned stood out to me as well. Obsessing and fear will perpetuate TMS. "Possible avascular necrosis" means it may or may not be. Also, a "partially torn" tendon would heal. Wouldn't you think?
I don't know exactly what you meant by applying the TMS techniques, but if you have been successful in the past, it must be very frustrating that it isn't working this time. What techniques have you used? (Re-reading? journaling? Challenging the pain with vigorous exercise? Speaking to a TMS trained counselor? Trying to let go and accept?)
Going the physical route with testing and treatments can also perpetuate symptoms because the mind knows it has you. Although it sounds like this has only been recently.
If Dr. Rochelle thinks you have structural damage in your foot, which test did he base that on and what is his diagnosis and suggested treatment?
Did you injure your foot at some point?
Is there anything going on in your life that would necessitate the continuation of symptoms? 3 1/2 years is a long time to have symptoms. Has the pain acted like TMS? For instance; moving, waxing and waning depending on life circumstances or physical condition?
Just a thought, but when I had neck pain (before I knew it was TMS), it would feel better when I was sick with a cold virus. I used to be puzzled by that weird fact. That is until I found Dr. Sarno's information.
If you had avascular necrosis, wouldn't it worsen over time? If there were nerve entrapment, wouldn't there be numbness? Aren't the spine Docs always promising to relieve pressure on the nerves in our backs due to bulging or herniated discs, to relieve us of our excrutiating years of back pain?
When you mention the various manifestations of TMS you have had, it makes me wonder. Have you had one thing after another? Have you had much time where you were pain free? Over what period of time have you experienced the symptom imperatives? Is it possible that you have been unable to identify underlying emotional issues, which has resulted in continuos manifestations of the same thing?
Sorry that my post seems to have more questions than statements. I'm just putting all my thoughts down. I feel for your situation and I sincerely hope you are able to resolve your pain soon.
Best
Peg
In questions of science, the authority of a thousand is not worth the humble reasoning of a single individual. Galileo Galilei |
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JohnD
USA
371 Posts |
Posted - 07/02/2008 : 19:04:11
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Obsessing can actually be a good thing because it forces you to take action on something that needs attention.
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Nor
152 Posts |
Posted - 07/02/2008 : 20:34:04
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Hi Warren,
I'm going on my gut here but it seems to me that those symptoms would worsen significantly over time. As long as that's not the case, I'd try the TMS approach in earnest. Perhaps its just a stubborn manifestation indicating you've got something new (emotionally) to uncover.
Nor |
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stanfr
USA
268 Posts |
Posted - 07/03/2008 : 06:01:00
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| Warren: I think La-kevin gave good advice. A 3d opinion isnt a bad idea, id certainly get one before getting surgery! I would stress that you ultimately should make the decision, don't make the mistake of putting your faith in one or another physician's diagnoses. You are the one who is best positioned to make your own diagnosis. I would seriously do all you can to research all these conditions, so that you can arm yourself with knowlege and be able to ask pointed questions to the MDs. When i had my first encounter with TMS (sciatica) i went to a medical library and read everything i could on the subject, by the time i was done i knew every nerve in my body and how they were connected! That's how i knew the doctors weren't really so sure of what they were telling me, they just used a bunch of big obscure words to make it sound like they did. So, make sure the answers you get are logical and consistent with your situation. The nerve entrapment diagnosis is particularly suspicious to me, that's always a fall-back when they really don't have a clue what's causing the problems. How specifically is this diagnosis made?? You have to be really skeptical and press for specifics. Ultimately, you have to decide what makes the most sense to you given your history. Bear in mind that for many of us who have had multiple manifestations of TMS or psychosomatic disorders, the latter appearances are often much more challenging to treat. Good luck, keep us posted! |
Edited by - stanfr on 07/03/2008 06:05:46 |
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Warren
USA
8 Posts |
Posted - 07/06/2008 : 10:30:34
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I appreciate everyone's input - very thought provoking posts. I am going to seek a third opinion from a TMS doc. In the last week, the diagnosis of a tear in a tendon in my foot has been confirmed. The doc I am seeing is recommending surgery to sew the tendon back together and remove any possible bone spurs. I also have been fitted for a very aggressive orthotic to take the pressure off of the ball of my left foot. I have decided to forego surgery for the moment.
So I had a plan until this morning - solicit the opinion of a third TMS doc, while using the orthotics to reduce the pain over the next several months. It all sounded good - then, I awoke with much more than usual pain in the same exact area of my foot - for no good reason! I did massage the area last night but have done so many times before with no resulting pain. The episode this morning almost has to be TMS! I have had the problem before of a combined physical problem and TMS. At one point, I had gout which was untreated and I would have severe inflammation and foot pain. During this same time period, I now look back and realize there was also many times that I had foot pain with no inflammation -i.e. TMS!
I have found my case of TMS to be very confounding and tricky. At times, I realize how much my unconscious mind is killing me, but I find it is very hard to stop. |
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stanfr
USA
268 Posts |
Posted - 07/07/2008 : 04:51:04
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Warren, there are many of us here that have gone through what you are going through. I elected to have sinus surgery 18 months ago because i was unable to fully accept that it was just another manifestation of TMS/AOS: i had a clearly deviated septum basically closing off the right side of my nose. Well, after the surgery when the congestion switched to the left side, i finally realized that it was TMS all along. TMS targets physical/structural weaknesses because they're easy scapegoats (how much the mind may actually contributes to these weaknesses is a whole other topic!) Please do not fall into the physical/structural trap--learn from my and other's mistakes.
How was the tendon torn? Do you know the exact cause of the tear?
I would say orthotics are a big mistake, it's playing right into that trap. That's why you woke up with 'more than the usual' pain--your subconcious knows you're on to its ploy so it's ramping things up to try to dissuade you. Been there, done that! The body has an amazing capacity to heal once the brain stops treating it as a victim. For example, when i had sciatica/herniated discs 12 years ago (which left me virtually incapacitated) the turning point for me was making the radical decision to go to the gym, and do strenuous back exercises, including rows with 180+ pounds of iron. From the medical perspective--this was completely insane! And the pain was excruciating at first--but it sure did drive the message home, because i recovered completely in short time thereafter, and havent had back pain like that since! |
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HellNY
130 Posts |
Posted - 07/07/2008 : 11:50:04
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"Trying to resolve this foot pain has obsessively dominated much of my thinking for years."
This is the root of it. The irony with TMS is the more you wish the pain would go away, the more it stays. |
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Conflicting Opinions from two TMS Docs
