Wednesday, May 1, 2013

My Life on Tarsal Coalition


I am writing this blog in the hopes of connecting with others who have faced chronic foot pain in their lives, specifically those who deal with the condition of tarsal coalition. Additionally, through my story, I hope to give understanding to those who love someone who is facing this condition.

It has been 699 days since I was last pain free. Before June 1, 2011, I was an extremely active 25-year-old law student. Exercise was my stress relief, and I thrived on running, biking, cardio classes, and virtually anything that got my heart rate pumping. At the time, I was training for my first long distance race, a ½ marathon. I was looking forward to the summer of my life: I had a great summer position with a law firm, was engaged to be married in just a couple of months, and was looking forward to experiencing my first summer away from my hometown, in the big city of Chicago. Then, 3 days before the race, I experienced sharp pains in my ankle while running. Being the stubborn (and sometimes idiotic) person that I am, I kept running and went to work that day wearing heels (it was only my second day on the job!). Well by the end of the day, my ankle was rapidly swelling to the size of a small cantaloupe. But that still didn't stop me, and I proceeded to walk on the injury around Chicago for 3 days. Finally, after some convincing, I went to the emergency room and was told that I most likely had a stress fracture and instructed to not put weight on the foot. No big deal, I thought. I was a bit sad to miss the race, but thought I would be back to running in no time.

Fast forward 2 years later, and I still am not running. In fact, I am barely walking, and it's a struggle to shower, run errands, or even just sit without thinking about the constant pain. Here is a quick overview of my situation. Since that day in June, I have had three surgeries. The second surgery was for a genetic condition called tarsal coalition. It took the doctors more than a year to discover this, but essentially, since I was a mere fetus, two bones in my foot had been growing together. Now, as this is a dominant gene trait, I was confused as to how no one else in my large family managed to come away with the condition. I must have won the genetic lottery.

The doctor performed a resection of my calcaneonavicular coalition, but sadly the pain was the same. After several more months and 1,000 of miles of travels to get second opinions, I learned I had anterior tarsal tunnel, which is an entrapment of a nerve (a more rare nerve entrapment than the common tarsal tunnel (which is like carpal tunnel in the foot)). Two months ago, I had surgery to release the nerve. As of now, I have yet to experience any pain relief, but the doctors again have given their favorite (and my worse nightmare) instruction: "give it more time."

As many romantic comedies would say, my situation is complicated. Every day is a struggle, but with the help of my husband, family, and friends, I have been able to deal with the daily emotional struggle. But not a day goes by where I don't wish I could go for a run, a walk, or even a sit without pain.


This picture represents the last day I wore heels, at my wedding in 2011.


36 comments:

  1. MJ. I'm truly sorry to hear about the pain. I am about 2 hours away from my orthopedic appointment in Manhattan Beach, CA. After looking at several pictures on Google, I'm pretty sure that my condition is a kind of tarsal coalition as well. In my case, it is only present on my right foot. During childhood, my parents thought it was just a flat foot, and I used to run, play soccer, do all kinds of activities like a regular teen. It wasn't until my mid 20's when I started to experience pain after playing soccer, limping the entire week only to try again the next week and expect the pain. Now 30, the pain is still there when I exercise and i cant keep up running along with my wife. Biking has become a better option for me. It's really unfortunate and even at work I have to take the elevators, and I had better come into work early otherwise parking is very far and I have to feel every step to my desk. Hopefully I can get a handicap placard where I dont have to walk as much into work. In any case, I'll let you know what the docs say and see if there is any chance of corrective surgery. Best and good luck. William. Is there a facebook page? wtovar007@gmail.com

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  2. Hi William,

    How did your appointment go? I hope you got some answers (even if not all good news). I'm sorry that your pain has continued to increase - it can have such a large impact on your quality of life.

    There is facebook page. It's a private group, so you have to request to be invited (but the good news is that any posts you make won't show up to your general friends). https://www.facebook.com/groups/120464547046/

    Keep in touch!

    Marcy

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  3. Hi, I lived in constant pain for 11 years due to a subtalar coalition. It ruled my life. I had it removed 3 years ago which caused my ankle to give up completely as it didn't know how to function with the added movement, and had several steroid injections into the joint to try and manage the pain. The steroids caused excess scar tissue in my joint which would limit any further treatment if continued. After a year of struggling on crutches I had my ankle fused with 2 screws. It took 6 months to learn to walk again without crutches and to build my muscles back up on my weak leg but I am now almost pain free. I can't walk as far as I'd like and I will never run again or jump about but I can deal with that. It has certainly been an experience. I even asked my consultant how I would go about having an elective amputation a couple of years ago. Foot pain can take you to some dark places. PS, I am also 27 :)

    Good luck xxx Tanith

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    1. How long has it been since your fusion?

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    2. Hi Linda - I never had a fusion, only a resection. Most of my current pain comes from nerve complications, but I shouldn't ever need a fusion at this point.

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  4. Hi Tanith,

    Thanks so much for posting! I so happy to hear that you are nearly pain free. I think the rest of us need that hope that we may too find relief someday. I spent most of 2012 thinking and wishing for an amputation, until I find did some research on it and learned about phantom limb pain - that scared me away!

    Good to hear from you,

    Marcy

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  5. Thank you for sharing. My son is in terrible pain right now with tarsal coalition in both feet. We are struggling through this trying to learn more so we can get him fixed up quick. I'll be reading all your entries now. Thanks so much!

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  6. Hey , thanks for sharing your story. I also remember that approximately at 25 years of age after consistent running schedule i started feeling the sharp pains until i could not walk normally only limp. Doctors say it is advisable not to power walk even. How do you lose weight in such a case?! :)

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  7. Thank you for sharing your story!! I know I am late on finding this blog post, but I really wanted to respond. My name is Morgan, I'm 20 years old and a junior in college studying dance and biology, but planning on making education my career. I was diagnosed with Tarsal Coalition when I was 9, so I've been dealing with it for over half my life. My goal is to just get through my college dance career because the pain can be so unbearable at times, and people just don't understand how bad it really can get. I can only run for short periods at a time, which is frustrating because I'm a very active person, or at least I like to be. I agree with your blog title, "when your feet hurt, everything hurts" because it's true and sometimes I don't even realize it because of how achy my feet are. I can't tell if I have chronic pain yet because I haven't officially been diagnosed but sometimes I just like to assume I do because of the severity. I know in the near future I'll have it along with arthritis in both my feet. Just wondering, how do you deal with the mental side of all this? I'm mostly a very happy, positive person, however I have days where I'm just like "I can't do this anymore" and it starts to freak me out.

    Thanks again for sharing and I would really appreciate if you would respond back!!

    - Morgan <3

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    1. Hi Morgan - I'm sorry for the delayed response, I hope you find this! The mental part of the chronic pain is so hard. Honestly, it was the biggest struggle for me, because like you I was a happy positive person, but the constant pain and uncertain future was a huge downer. I ended up going to counseling and it helped immensely. I had trouble talking to loved ones about the pain because I didn't want to be a complainer, but it really helped to talk it through with another person and learn that my feelings were ok and that there was much more to life outside the pain. Hang in there!

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  8. I didn't realize so many people suffered from tarsal coalition. I am now 32, but as an active teenager, my mother and I spent many years with 11 doctors and 3 surgeons trying to figure out what was wrong with my ankle. The pain became unbearable and I had to crawl every morning for about a half hour before having enough strength to stand on my feet. I elected for the fusion surgery with a 5" screw when I was 17. Total recovery was about a year until I was no longer limping. Shortly after recovery, the issue accelerated in my other foot and I went back in for the same surgery on my opposite foot. While I didn't gain increased mobility, it did eliminate most of my pain, I no longer had to crawl, and my ankles no longer "gave out", randomly causing me to fall. Until I was almost 30, I had so much fear and anxiety about my feet, that I wouldn't run, jump, etc. But I've since conquered those fears and I now mentally push myself to see what I'm able to accomplish. Last year, I slowly jogged five 5Ks, and this year I have my eyes on a 10K. Next year will be a half marathon. I just wanted others to know that surgery can be a successful option. I'm also curious to connect with others who may have had the fusion surgery to hear how your long-term experience has been.

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  9. I didn't realize so many people suffered from tarsal coalition. I am now 32, but as an active teenager, my mother and I spent many years with 11 doctors and 3 surgeons trying to figure out what was wrong with my ankle. The pain became unbearable and I had to crawl every morning for about a half hour before having enough strength to stand on my feet. I elected for the fusion surgery with a 5" screw when I was 17. Total recovery was about a year until I was no longer limping. Shortly after recovery, the issue accelerated in my other foot and I went back in for the same surgery on my opposite foot. While I didn't gain increased mobility, it did eliminate most of my pain, I no longer had to crawl, and my ankles no longer "gave out", randomly causing me to fall. Until I was almost 30, I had so much fear and anxiety about my feet, that I wouldn't run, jump, etc. But I've since conquered those fears and I now mentally push myself to see what I'm able to accomplish. Last year, I slowly jogged five 5Ks, and this year I have my eyes on a 10K. Next year will be a half marathon. I just wanted others to know that surgery can be a successful option. I'm also curious to connect with others who may have had the fusion surgery to hear how your long-term experience has been.

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  10. It is nice to know that I am not the only one. Sometimes it is a lonely condition. No one really understands how painful it can be. I can go from walking fine to having level 8 pain within hours. I have had people ask me if it actually hurts that bad like I am faking it. I am so tired of dealing with the chronic pain. It makes me so tired.
    I had bilateral coalitions and I had resection on both of them. My left one feels amazing but my right one is still painful. I feel like it could be from the nerves because the resection looks really good. I am a freshmen in college and it has been very difficult for me. I go back to my dorm room and cry a lot because it hurts so bad. I haven't been able to run for a year and I have had to limit myself a lot. I was really active before all of this started.

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    1. Oh this sounds so so so similar to me - it ended up being nerve pain for me, so please have a specialist look into it!

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  11. I started experiencing extreme pain in my left foot when I was 9 years old. At first, my parents thought that I had just sprained my ankle and they ignored me when I said it hurt. After about two months of complaining, my dad took me to the doctor, they took x-rays of my foot, and said there was nothing wrong. So, my parents obviously didn't believe that I was experiencing extreme pain because the doctor said there was nothing there. For the next six years, my foot would go through phases of hurting and not hurting. I would be fine on a day to day basis. However, if I walked around a lot, at the zoo for example, my ankle would swell up to the size of a softball and I wouldn't be able to walk for three days. Then I would limp for another week. After that, my foot would go back to normal until my next session of strenuous activity. After much more complaining, my dad took me to another foot doctor when I was 15. This guy said that I had bone spurs on the top of my foot, but he didn't understand why that was causing pain in my ankle joint. Oh well. He prescribed $400 shoe inserts (which I did not buy) and injected some cortisone into my foot. That worked for about two months. After it wore off, my foot kept on hurting. I came to accept that my foot was going to hurt for the rest of my life. Two years ago, I got a job at a daycare. Naturally, I have to be on my feet all day long. People with this condition can imagine what it is like to stand all day, especially on a hard floor. I would have to tie my shoes so tights that the circulation was cut off just to be able to walk. I would go home with a swollen foot and would have to use crutches the rest of the night. Then I would take multiple advil and start the day over again. After about a year and a half of that, my mom made an appointment with this really top notch podiatrist in Pittsburgh. We went to see him, and within 15 minutes he knew exactly what was wrong with me. He scheduled an MRI to confirm it was a tarsal coalition and within a month I had the joint fusion surgery. I spent all summer sitting on the couch recovering. I really have to thank my parents and my sister for helping me through this. I wasn't even about to shower or go to the bathroom by myself for a month. The pain wasn't as bad as I thought it was going to be. I got a nerve block, which wore off after 36 hours. After that, I had to take 2 percocet every couple of hours because the pain was so intense. I only had to do that for a week and then I was fine. The doctor had me on a asprin regime because he was worried about blood clots because I was sitting around all summer. There was nothing else to do! I was so excited to have a solution to the problem that has been bothering me for 10 years!

    The doctor told me that I should be able to walk in 8-10 weeks. Well they came and went and I was not able to walk. I figured my muscles were a little weak and that was natural. When week 15 came, I still wasn't able to walk and I had to start college in rural Pennsylvania with hills everywhere. It was a nightmare. I still wasn't able to walk without crutches for over four months. I just had another follow up exam last week and the doctor doesn't think the joint fusion is healing properly. I have to get another CT scan and depending on what that shows, I might have to get this whole surgery done again. Terrific!

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  12. Hi, Im 28 and I have a fibrous coalition in my subtalar joint. Ironically enough, I'm a recently graduated Physical therapist. My ankle pain did not really start to significantly effect me until half way through grad school. Now that I am graduated, and in a lot of debt, I am very scared that my pain will prevent me from working long enough to pay off my debt.
    However, there is a silver lining. Because I was in PT school when my symptoms became severe, I was able to quickly figure out what I had, and how best to treat it. In truth, the best way to treat coalitions depends on the specifics of the coalition. It depends if it is boney, cartilaginous or fibrous. It depends on if the coalition is in the calcaneo-navicular joint, or subtalar joint, or another. It depends if the tarsal coalition causes the hind foot to be stuck in a varus, valgus or neutral position. It depends on what percentage of the surface of the joint is comprised of the coalition. And most importantly, it depends on the age of the person.
    In children before the age of 12-14, surgery is the best option because it lets the bones have an opportunity to re mold themselves before the bones completely ossifiy and mature (there is of course still an inherent risk to surgery and there is no guarantee). After 16, surgery should probably be put off as long as possible. For many, the best option is CUSTOM MADE ORTHOTICS (and of course, you have to find somebody good. A bad pair of orthotics will not help you much at all). For myself, I needed a pair of orthotics to reduce stress on my subtalar joint to minimize the abnormal forces place on it. From personal experience, these orthotics are the only thing that help me get through the day with only minimal pain. (I have been very surprised by the lack of mention of orthotic use in the above posts and on other blogs, it should be tried by everyone with coalitions because it attempts to correct abnormal forces on the joints).
    Unfortunately, activity modification is important as well. This means, biking, swimming, kayaking instead of running. Also, icing and heat help to reduce inflammation. A lot of the pain is from abdnormal motion at the joints of the foot which causes inflammation. Some times I ice and heat my ankle when I get home from work and it helps a little to reduce inflammation. If you can, a desk job helps a lot.

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  13. (Im continuing from above because I ran out of room)

    Finally, if all options are exhausted, then surgery may be an option. The prognosis for sugery will be based on the many factors which I listed above and will be best communicated by your surgeon. I believe they first try to resect the coalition, and if that still causes pain they will then fuse it. I personally have trouble believing any resection can be done without a subsequent fusion after adolescence unless your extremely luckly. After the bones have fully matured, they will not be able to adapt to excessive motion placed on the joint after a resection, therefore a fusion will most likely need to take place. However, like i said earlier, every coalition is different and the best treatment may very from person to person. One last point I think I should make is that coalitions are fairly uncommon, and that means that even many orthopedist are not good at diagnosing them, or miss them all together. I've been reading about how many people on earlier posts who have been mis diagnosed. This is not uncommon with any condition, even a complicated and rare one like a coalition. So i guess what I'm saying is, always seek a second and third opinion. You'll have a good sense when your finally speaking to someone who can give you some answers.
    I hope my advise or knowledge may be helpful to some. However, it is a difficult situation which I can fully relate to. I am full of apprehension and fear that I will not be able to make a living in the near future or will find my self undergoing many surgeries and still be in pain like many who have the condition. On the other hand, it is very important to have a good outlook and realize there are those that are able to deal with their discomfort with custom made orthotics or have successful outcomes with surgery.
    If anybody lives in the long island area, I would love to meet up. I live in Stony Brook Long Island.

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    1. Hello! I am also on Long Island! My 9 yo daughter was just diagnosed with TC. I would love to talk to you, I am also a PT.
      Thank you,
      Christine

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  14. (Im continuing from above because I ran out of room)

    Finally, if all options are exhausted, then surgery may be an option. The prognosis for sugery will be based on the many factors which I listed above and will be best communicated by your surgeon. I believe they first try to resect the coalition, and if that still causes pain they will then fuse it. I personally have trouble believing any resection can be done without a subsequent fusion after adolescence unless your extremely luckly. After the bones have fully matured, they will not be able to adapt to excessive motion placed on the joint after a resection, therefore a fusion will most likely need to take place. However, like i said earlier, every coalition is different and the best treatment may very from person to person. One last point I think I should make is that coalitions are fairly uncommon, and that means that even many orthopedist are not good at diagnosing them, or miss them all together. I've been reading about how many people on earlier posts who have been mis diagnosed. This is not uncommon with any condition, even a complicated and rare one like a coalition. So i guess what I'm saying is, always seek a second and third opinion. You'll have a good sense when your finally speaking to someone who can give you some answers.
    I hope my advise or knowledge may be helpful to some. However, it is a difficult situation which I can fully relate to. I am full of apprehension and fear that I will not be able to make a living in the near future or will find my self undergoing many surgeries and still be in pain like many who have the condition. On the other hand, it is very important to have a good outlook and realize there are those that are able to deal with their discomfort with custom made orthotics or have successful outcomes with surgery.
    If anybody lives in the long island area, I would love to meet up. I live in Stony Brook Long Island.

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  15. Hi,
    I was diagnosed with a fibrous tarsal coalition. I am desperate and have yet to find something that help. Right now I am trying very aggressive deep fascia tissue massage. Anyone know if this has potential to work?

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  16. Not sure about the fascia tissue massage, but I'm 9 days post op for a fibrous tarsal coalition; I'm moving but still have pain. Keep me posted re the massage. Hope that resolves your prob.

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  17. I was diagnosed with Tarsal coalition about 10 years ago. I have a bilateral resection of the joints 8 years ago and last year resorted to fusion of the calcaneus, navicular, and cuboid bones in my right foot. I still have no relief. Although I'm mobile, I still have to decide what I can do vs how long will I pay for doing that activity. There is NO quality of life. I am now pleading my case to amputate. I had no idea there were so many with this condition yet medical advancement is still so medieval concerning our care.
    Thank you for sharing

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    1. Hi Julie, I was wondering how you got on with pleading your case for amputation. I have been dealing with this condition since I began to walk(and couldn't without screaming apperently). I'm 35 now, I've had 3 resects done, (1 on each foot at age 11 and 1 on my right foot 7 years ago) I went to see my surgeon on monday last week and he said theres nothing he can do so I'm concidering amputation as I can't live with this any longer. did your surgeon agree or did you seek further help from another?

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  18. Hi, I am 33 years old. I started having pain in both my feet and ankles when I was about 11 or 12. I had a hard time in pe doing the stretches to touch my toes. I could never do them my teacher would get so mad but it hurt really bad and my feet would not move upward at all. I was active I walked alot and loved to rollar blade but it killed me afterwords. In my teenage years it got even worse so I went to the docter and they diagnosed me with ra and lupis.I started seeing a ruemotologist. The docter tried every medicine he could think of up until I was about 27 but then he told me I don't know what to do for you if nothing helps. I think it was in my early 20s when it got so bad I could barely walk sometimes crawling because it hurt so bad to stand or walk. One day I decided I've had enough I'm going back to the er. I seen a docter he took xrays and found out I had tarsal and subtalar coalition in both feet. He couldn't believe after having other xray done no other docter seen it. 2 years ago I decided to have surgery done on one of my feet only to find out the surgery did nothing but make my pain 100 times worse. I think that the surgeon screwed up my foot worse. The pain that tarsal coalition and subtalar coalition gives is something I wouldn't wish upon anyone. I can barely walk, and I always walk with a limp. Everyday I would rather cut my feet off or die rather then go through the pain I do. I

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  19. Hi, I am 33 years old. I started having pain in both my feet and ankles when I was about 11 or 12. I had a hard time in pe doing the stretches to touch my toes. I could never do them my teacher would get so mad but it hurt really bad and my feet would not move upward at all. I was active I walked alot and loved to rollar blade but it killed me afterwords. In my teenage years it got even worse so I went to the docter and they diagnosed me with ra and lupis.I started seeing a ruemotologist. The docter tried every medicine he could think of up until I was about 27 but then he told me I don't know what to do for you if nothing helps. I think it was in my early 20s when it got so bad I could barely walk sometimes crawling because it hurt so bad to stand or walk. One day I decided I've had enough I'm going back to the er. I seen a docter he took xrays and found out I had tarsal and subtalar coalition in both feet. He couldn't believe after having other xray done no other docter seen it. 2 years ago I decided to have surgery done on one of my feet only to find out the surgery did nothing but make my pain 100 times worse. I think that the surgeon screwed up my foot worse. The pain that tarsal coalition and subtalar coalition gives is something I wouldn't wish upon anyone. I can barely walk, and I always walk with a limp. Everyday I would rather cut my feet off or die rather then go through the pain I do. I

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  20. Hello, reading this has helped me as I am in the same boat. I am a 21 years old female. This has caused me so much pain, struggle and a hinderance in my life with school,work, to wanting to learn to drive even to the littlest things I enjoy like going the gym :(

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  21. I too have been diagnosed with tarsal coalition and have had the resection surgery with no relief. I am also 46 and have asked the doc from day one to just cutt it off. He assured me the resection would be the answer it wasn’t. Now he wants me to try physical therapy before we go onto the fusion. I am thinking therapy would be a waste of time and money. So tir d of not being able to walk

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  22. Woow, many people with the same condition I have. I was diagnosed with tarsal coalition about 3 years ago. I am now 41. Since that time, the pain is on and off. I tried reflexology and it really helped. Ibuprofen helps too. Im thinking about getting steroid injection for the pain as im going in a holiday and i dont want to ruin it for my family. Btw I use orthotics and the teally help

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  23. I've found my people. I was just diagnosed with a calcaneonavicular coalition after being treated for three years for peroneal tendonitis and finally insisting that I get imaging done. I started feeling foot pain about five years ago but thought maybe it was just a part of aging. But it got so bad, and I noticed my friends weren't suffering like this, so it had to be something out of the ordinary.

    Doctors up to now have been ... less than helpful. I first thought it might be arthritis, as it runs in my family. And I do have arthritis in my feet (which I know will probably complicate things), but the rheumatoligist said it wasn't at the stage to be causing the kind of pain I told him I'm having. "Well, everyone gets tired feet," he said !!!

    And the podiatrist, like I said, would have been happy to treat me for tendonitis forever, apparently. He wanted me to pay out of pocket for some laser treatment that insurance won't cover. The look of shock on his face when he saw the result from the MRI was rather amusing. All of a sudden, the laser treatement wasn't an option anymore, and he was talking about sending me to an ankle specialist.

    But I'm so, so tired of this. This pain has ruled my life now for years, deciding everything from whether I go grocery shopping from one day to the next to which jobs I will apply for. I want my life back. I thought I was the only one who fantasized about not having feet anymore, but I see others here have, too.

    When I got my diagnosis, I broke down and cried in my car, because for months and months I'd been pretending it's not been as bad as it is, but the truth is, I can't stand it anymore. It's really awful. It's always there, even when I'm doing nothing. There are things I want to do in this life and I feel I'll never get to do them because I'm always wondering, do they have a cart available? Do they have chairs to sit in? Will I have to be standing for any length of time? I hate this. Even gardening takes a herculean effort.

    I can't wait to get in to see this ankle specialist and I don't care what he does so long as he makes the pain stop. Just. Make. It. Stop.

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    1. Helloninwas wondering how you are doing as of October 2020. I was just diagnosed with the exact same. In alot pain for a few months that is just getting worse. Being told I should do fusion of this joint and subtalar joint for arthritis as well. Would love the hear if you found healing or relief.

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  24. An insole in my shoes was a miracle for me. However, i had episodes of pain from time to time. A steroid injection in my ankle reduced those episodes. I think im happy now with it.

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  25. I was diagnosed at the age of 8 but at that time they didn't know surgery could possibly help I have muscle spasms and pain daily but I just push through it since I've lived with it for so long I'm 36 now one of my doctors explained because of where my joints are fused in my pinky toe region the muscles never relax in my foot and was shocked that I'm even able to walk, my issue was my records were never transferred when I moved and now I would have to be diagnosed and they were going to send me to a specialist again but haven't I'm hoping to get my doctor to do so at my next appointment I have

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  26. Hello this has been a help. I have bad tarsal coherence on both feet. I was on the wrestling team but decided to quit because of all the pain. I joined my schools swim team and have been doing much better except for weight days,those still hurt like heck

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