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Doc answered all my questions. Yay doc!
Q1) Yes, I may have more than just the neuromas going on. Probably some metatarsalgia and some generalized inflammation from unconsciously modifying my gait.
Q2) Metatarsal arch support is a good idea and can be added to the insoles I already have.
Conclusion 1: We're sending the insoles back to the manufacturer to get lumps put in the right places. (I hope they really do hit the right places. Placement, as I have learned with my bits of moleskin and as the doctor confirmed today, is critical.) Sadly, I'll need to live without the insoles for a couple of weeks. That feels decidedly weird now.
Q3) No, there's no other nonpermanent approach. Counting the arch support, we've tried 'em all.
Q4+) Alcohol injections:
- Low percentage of patients choosing alcohol injections go on to need surgery. Too few to give a percentage number. In his practice, so far, it's two. EDIT Dec '04: He's done this for fifty or sixty people, making the need-surgery-afterwards rate around four percent.
- None regret it, to his knowledge.
- Weird pain or phantom sensations: only for the first couple weeks.
- Yes, complete numbness of one toe and of half of the two beside it.
- No effect on motor nerves.
- Whole nerve including tumor will be dead. Body doesn't eat them, as sometimes happens with dead stuff (eg a bruise); it will just sit there, nonfunctional, like an appendix.
- Only the tiniest chance of ever regaining sensation. Would take decades. Unlikely even then.
- No contraindications of any kind for running, dancing, rock climbing, or other activities that make heavy use of the feet.
- Injections are less painful than the ones I've already had.
- Surgery, if needed, would be done through the top of the foot; secondary surgery (eg if I had a stump neuroma develop after a first surgery) is done through the bottom and requires no weight bearing for two weeks.
Conclusion 2: If the metatarsal arch support doesn't work, I'll do the alcohol injections. Yes it's permanent... but it's time I got my mobility back in full, and this will do it.
Q1) Yes, I may have more than just the neuromas going on. Probably some metatarsalgia and some generalized inflammation from unconsciously modifying my gait.
Q2) Metatarsal arch support is a good idea and can be added to the insoles I already have.
Conclusion 1: We're sending the insoles back to the manufacturer to get lumps put in the right places. (I hope they really do hit the right places. Placement, as I have learned with my bits of moleskin and as the doctor confirmed today, is critical.) Sadly, I'll need to live without the insoles for a couple of weeks. That feels decidedly weird now.
Q3) No, there's no other nonpermanent approach. Counting the arch support, we've tried 'em all.
Q4+) Alcohol injections:
- Low percentage of patients choosing alcohol injections go on to need surgery. Too few to give a percentage number. In his practice, so far, it's two. EDIT Dec '04: He's done this for fifty or sixty people, making the need-surgery-afterwards rate around four percent.
- None regret it, to his knowledge.
- Weird pain or phantom sensations: only for the first couple weeks.
- Yes, complete numbness of one toe and of half of the two beside it.
- No effect on motor nerves.
- Whole nerve including tumor will be dead. Body doesn't eat them, as sometimes happens with dead stuff (eg a bruise); it will just sit there, nonfunctional, like an appendix.
- Only the tiniest chance of ever regaining sensation. Would take decades. Unlikely even then.
- No contraindications of any kind for running, dancing, rock climbing, or other activities that make heavy use of the feet.
- Injections are less painful than the ones I've already had.
- Surgery, if needed, would be done through the top of the foot; secondary surgery (eg if I had a stump neuroma develop after a first surgery) is done through the bottom and requires no weight bearing for two weeks.
Conclusion 2: If the metatarsal arch support doesn't work, I'll do the alcohol injections. Yes it's permanent... but it's time I got my mobility back in full, and this will do it.
