Sunday, January 20, 2013

Plantar Fasciitis: My Experiences and My Bi-Lateral Topaz Technique + PRP Surgery

WARNING:  Lots of words ahead… mostly about feet!

Since this blog is primarily a record for myself, I want to write about my experience with plantar fasciitis in both feet for the past 1.5 years.  I talk about it a lot but hopefully putting it in writing will give me some perspective and possibly help someone else down the road.

My journey down the podiatry rabbit hole starts in Sweden... Well, sort of.  During a work trip to Sweden on December 2011, I had some free time which we spent primarily south of Sweden in Copenhagen, Denmark to be specific.  My coworkers and I were shopping on Strøget when what had been occasional pain in both of my arches and heels became non-stop.  By the end of my trip, I was tip-toeing through our office in Lund and airports in Copenhagen, London and Philadelphia because I couldn't stand to put weight on my heels at all.  (Sidebar--Reva flats may be cute but they may as well be outfitted with nails in the heels for how painful they can be for individuals with this injury--NOT the best footwear choice!)

I kept running as much as I could stand it, and bought Dansko clogs as a concession to obviously needing more supportive footwear.  In early 2012, I finally got referred to a podiatrist convenient to me who came highly recommended.  In fact, I would still recommend this office.  I was quickly diagnosed with plantar fasciitis in both feet (which an MRI would later confirm when I still wasn't getting any better.).  Here’s what happened next:  Ttwo rounds of cortisone injections in both feet (not recommended and it did nothing for me), strapping (multiple times) to help better support the fascia, various NSAID prescriptions (didn't alleviate my pain and Daypro made me nauseated and lightheaded), many different kinds of stretches, night splints, no running at all for about 8 months, prescription orthotics, supportive footwear, the aforementioned diagnostic MRI, and three months of intense physical therapy.


In other words, my podiatrist tried very hard to work with me to avoid surgery at all costs.  Here's what helped the most:  orthotics, stretching and PT.  Unfortunately, these efforts were not enough and my PT and podiatrist came to the same conclusion:  I was that rare patient who needed surgery.  Prior to going under the knife, I even had various blood panels run to rule out less common diagnoses for why I had so much pain (I.e. rheumatoid arthritis).  I am convinced my unusually high arches, high activity level and apparent poor healing response were the trifecta that placed me in Paoli Hospital in November 2012.


I was so sick of planning my life (and wardrobe—and I LOVE LOVE LOVE shoes) around literally constant foot pain.  Some days were better than others, but standing-walking heavy days like the back to back weeks I spent in New Orleans and Las Vegas were times I eventually found it nearly impossible to walk or stand.  I would have to consider social invitations very carefully-if I go this bar, will there be seating?  Can I stand a shoe with hard support today or do I have to wear a squishy sole because my pain is so intense?  Questions like this and pain were consuming my life and turning me into someone I didn't like very much--obsessed with my pain and frankly, pretty nasty a lot of the time.  Also, I've been running since I was 12, and the inability to do it at all or as much as I'd like depending on the degree of pain was making me crazy.  I avoided surgery longer than I probably should have, but eventually decided to for all the above reasons.


My podiatrist was also my surgeon, and he no longer performs the "old-school" plantar fasciitis surgery, which consisted of actually cutting the fascia in hopes of reducing the pressure/inflammation of stressed fascia tissue.  The side-effects of this surgery are often as bad as the injury itself and he felt the clinical outcomes weren't good enough to continue to perform this surgery.  The procedure I had is somewhat unusual as it combines a newer surgical technique with another one and I had it bi-laterally; most doctors will have their patients have each foot done separately if the injury is bi-lateral.  I had an outpatient “needling” type procedure done on both heels called the “
Topaz” technique which was immediately followed up by Platelet Rich Plasma (“PRP”) injections in the side of both of my heels were the fascia joins together.  Both techniques are purported to illicit a hyper-inflammatory response which in theory should force one’s body to heal itself as though the area had been acutely injured once more. 

Although the procedure was considered outpatient, I spent the better part of the day in the hospital.  I went under general plus local (knees-down) anesthesia for this procedure.  I don’t do incredibly well with anesthesia (low heart rate and extreme post-anesthesia nausea) and it was not surprising I spent a long time in recovery.  Other than feeling extremely nauseated and dizzy and weak (my heart rate was averaging around 39 bpm for awhile and required constant monitoring), I don’t remember much about that evening. 
I can attest to the hyper-inflammatory response the surgery is supposed to cause; I was on Percoset (taken simultaneously with Zofran as I vomit otherwise) for a couple of weeks after the surgery, then Vicodin and Neurontin for a week or two after that.  (Sidebar… those pain pills are the WORST.)  For awhile the pain would keep me awake at night and I was unable to walk aside from the occasional trip to the bathroom on my tippy-toes.  Putting any weight on my heel area whatsoever was an absolute no-go for a week.  I came back to work after a week but evening walking around the office proved extremely painful and difficult and I wasn’t able to come in every day the 2nd week post-op.  I would say the 3rd week is when I began to notice a significant improvement in the severity of my pain and a little after a month post-op, I started 3x/weekly physical therapy sessions again.  Tomorrow is the 10 week mark and although I feel MUCH better than I did even 4 or 5 weeks ago, it’s still too early to tell if the surgery worked.  I have days/times with significant pain and I’m still unable to stand or walk for any great length of time but I can now get around pretty normally.  Running is still a pipe-dream and as are any shoes with any type of heel that comes to a point on my heel (here’s hoping!!!).  My physical therapy session last week showed several degrees of improvement in the flexibility of both of my feet, so I am still positive.

The best advice I can give anyone is this:  Treasure the feet you have!  For example, don’t pretend flip-flops are legitimate footwear.  Baby your feet, stretch, don’t take them for granted (MAN I am jealous of a time when I could do this) and don’t ignore persistent pain that wasn’t there before.  Feel free to e-mail me if you’re going through this too and have questions.  I will be posting a brief follow up in a couple of months. Warning, foot picture below (not particularly graphic, but still!)
















 

a couple of weeks post-op

Monday, December 31, 2012

Our 1st Wedding Anniversary

Wedding photo credited to Carden's Photography
 We celebrated our first wedding anniversary on October 29th.  Much like our honeymoon, my DH surprised me with our trip location and plans.  For our honeymoon, I didn't find out where we were headed until the end of our reception.  For our first anniversary, I didn't find out until about 20 minutes into our car ride there!

Since we were unable to go with our original plan of Amsterdam/Belgium because of less available vacation time for my husband, he wanted to plan a weekend fairly close by involving some of our favorite things:  hiking, good food and wine (to be fair, DH prefers whiskey haha).  He chose New Paltz, NY for its proximity to good hiking, as well as a picturesque location and good food, beer and wine.
Celebrating our anniversary at Lombardi's with champagne compliments of the B&B owners!
Downtown New Paltz at dusk


Enjoying the amazing beer selection at Bacchus

Tasty beer and a fun time at the Gilded Otter
We stayed at a bed and breakfast, Mountain Meadows, which was delightful.  Although our room wasn't fancy, it was very comfortable (and quite large).  The homemade breakfast every day was incredible (baked spinach eggs, homemade applesauce with fresh cinnamon whipped creme, homemade muffins, etc.) and the owners were extremely friendly.  We really enjoyed the fireplace, hot tub and genuine advice about where to go and what to do in the area. 

Mountain Meadows B&B


View of the Shawangunk Mountains from near the B&B


We went hiking in the Shawangunk Mountains, completing a hike between 8-9 miles around Mohonk Preserve.  It was GORGEOUS!  Highly recommended for hikers and well-known for excellent rock climbing.

Starting our hike

Lake Mohonk




One year!

I LOVE Fall!!!

Amazing rock formations

We made it all the way to Lake Awosting!


We also visited some tasty restaurants as well as two wineries on the Shawangunk Wine Trail--Robibero Family Winery and Whitecliff Vineyards.  We had a great time at both wineries and enjoyed wine at both places.  Whitecliff has been in business for a longer time and I personally enjoyed their wine the most.  Tasting at both wineries was very personalized and we got a lot of individual attention--we were really the only visitors at either winery with Hurricane Sandy expected to hit the next day (which, unfortunately, it did).  From Robibero we brought home 87 South and 87 North and from Whitecliff we brought home Red Trail and Traminette (especially tasty!).

Robibero Winery

Whitecliff Vineyard


We had snow on our wedding day (unusual here in October) and our actual 1st wedding anniversary was the day Hurricane Sandy hit so we left early that morning in order to beat the storm.  The weather on both days has served as a reminder of how blessed we are as a couple.  We had a beautiful wedding and despite losing power for a week during Hurricane Sandy, we fared much better than many of our east-coast neighbors, some of whom are still without a place to call home.  (Please consider donating to the Red Cross to help those still in desperate need of assistance!)  Marriage is an adventure, and we consider ourselves pretty lucky!  Here's to many more adventures!

Sunday, December 16, 2012

MODG's Operation Wana

One of my favorite blogs of all time is MODG.  She is also lives in the suburbs of Philly, and she is HILARIOUS.  I love somebody who has an authentic voice on their blog and isn't afraid to keep it real (and occasionally, controversial). 

Last year, MODG did an awesome thing called Operation WANA (click her blog to find out what this acronym stands for haha) where readers of her blog could help each other out via comments.  I encourage everybody to consider participating.  This is truly what the Christmas season is about and a unique way to help or support other ladies in the blogosphere.  Click here for the post to participate:  Operation Wana 2.0

Saturday, December 8, 2012

St. Augustine Wedding, September 2012

In September, my oldest friend C married B in St. Augustine, Florida.  This is the same couple we celebrated with in Las Vegas in July.  I could not be more happy for her; B is truly her perfect match!  The DH and parted ways and I flew solo for this blessed event as his cousin was getting married the same day in D.C. (along with several other people I know--popular wedding day this year!).

C asked me to be a bridesmaid, which was a huge honor and the first time I've ever been in a wedding (aside from my own!).  The other women C chose to be her attendants were SUCH a fun bunch and I can honestly say I'd love to hang out with all of them on a regular basis.  C is truly blessed! 

6 of the 7 bridesmaids with the bride!

Love that fanny pack! Haha

Hanging out in the carriage on the way to the reception


I have been to Florida many times in the past, but I'd never had the opportunity to visit St. Augustine until C's wedding.  It was beautiful!  Aside from all of the wedding festivities and of course the actual event itself, one of my favorite memories from my trip was getting up early the day before the wedding and going on a run along the paths surrounding Castillo De San Marcos (the oldest fort in the U.S.) and across the intracoastal waterway as the sun was beginning to rise!  A photographer was doing an early morning fashion shoot as I ran by... pretty surreal.



View of the fort


B's heritage is Irish and the wedding attire, colors and theme reflected Ireland.  The groom, his guys and both fathers wore kilts and other traditional Irish garb.  It was the first wedding I've ever been to with this attire and it was awesome!  The pictures turned out so well and it was a fun nod to B's family. 

Handsome groom!


In keeping with the Irish theme, C let us pick our favorite short, satin dress in a holly green shade from David's Bridal.  I was admittedly skeptical about their dresses, but the color C chose was GORGEOUS, honestly looked great on everyone, and all the ladies were comfortable because we got to choose the dress style we liked the best.  Unfortunately, David's Bridal has since discontinued this color--note to their corporate office--bring it back!  I am certain I will wear my dress again since I really do love the color and it's really just a simple, fitted cocktail dress.  C also got her dress from David's Bridal, and she looked beautiful and classic.  

The bridesmaids' gold shoes (mine are on the far right) and C's awesome green platforms

Beautiful bride!


I could wax poetical about this wedding for a long time because it really was a special series of events and I have been friends with C since 6th grade.  However, I will end in saying good friends, loving family and unique, historic location made for a great weekend! 

Just married!


Cutting the cake during their beautiful reception at The White Room



Casual Holiday Party

Saturday, December 1, 2012

Vegas, Baby!

The last weekend of July 2012, A and I headed to Las Vegas for some brief alone time and to celebrate C and B's bachlorette/bachelor party.  Despite a rocky start for C and B due to a weather delay and some brief weather delays of our own, this was a great way to close out a really crazy month of traveling!

Neither A nor myself have ever been to Las Vegas, and the excuse to visit to celebrate my oldest friend's bachelorette was the perfect opportunity to go!  C and B chose to stay at the Treasure Island Hotel and Casino and although it is not a fancy hotel, our room was newly re-done (nicely so), very comfortable and spacious and had an enormous bathroom!  We also had an excellent view of the Strip (in particular the Wynn and Encore Hotels and the Shops at the Forum) and the nightly Treasure Island Pirate Show and I would recommend Treasure Island as excellent value for your dollar.

Treasure Island!

Pool at the hotel

View around the pool

View from our hotel room!


A and I arrived a little more than a day ahead of everyone else, and had time to explore.  We went up and down the strip, browsing the Shops at the Wynn, Ceasars Palace, and taking the public bus upon the recommendation of the concierge (the cheapest way to travel as cabs in Vegas are very expensive and you don't want to walk in literally 108 degree weather) to go the top of the Stratosphere Hotel upon the recommendation of my friend K who has been to Vegas many times.  The view from the Stratosphere was incredible (you're about 112 stories right above the Strip) and we rode the Big Shot ride on the tower, which shoots you up and down the very top of the tower.  The ride must be all of 20 seconds long, but that's enough--we both felt like we were going to free-fall onto Las Vegas Blvd!  Highly recommended for the incredible views of Las Vegas and the surrounding desert from the tower and for the thrill of the ride itself.

The Stratosphere... the tower is on top of this!

108 stories up at this point!

Las Vegas. Blvd.

Beautiful mountains in the distance



We had a nice afternoon  trying not to burn our skin soaking up the rays (and avoiding spontaneous combustion... DANG it was hot) and relaxing at the pool at our hotel (although I didn't experience the drink that comes in a toilet shaped glass... yuck).  That evening, upon the recommendation of my friend A, we went to the Paris Hotel and Casino, for the sole reason of dining outside at the delightful steakhouse Mon Ami Gabi, which is located directly across Las Vegas Blvd. from the Bellagio.  We ate delicious steak with pomme frittes, drank champagne with St-Germain and had the perfect view to watch the Bellagio light/fountain show (multiple times).  It was a great day and date night!

Ready to go out!

View of the Bellagio from our seats on the terrace of Mon Ami Gabi

"Paris" Eiffel Tower

The Bellagio and foot traffic



The next day, C and B arrived along w/ C's sister M, and C and B's truly awesome (and newly engaged) friends K and M.  We started with cocktails outside by the water features at Wynn's Parasol Down bar.  It was so hot that after about 2 or 3 minutes in direct sunlight, my iPhone quit working.  That dry heat is crazy because you don't realize how hot you are until you're REALLY hot!  After heading back to our hotel to relax, we cabbed it to the Aria Hotel to eat dinner at the truly awsome restaurant Sage (thank you Yelp for another fabulous suggestion!).  We got the early dinner tasting menu (get seated by 7pm; you'll still qualify for the "early" menu and save $40/pp off the normal tasting menu rate) and all 7 of us agreed it was one of the best meals any of us had had in a long time.  Worth the money and the ambiance is beautiful and a nice break from the insanity often present in Vegas.

Water feature at the Wynn

Groom and Bride-to-be Enjoying drinks at Parasol down

Laides ready to leave for dinner



Ready for dinner at Sage-entire group

Inside Sage


After dinner, and a brief visit to see the opulent lobby and famous ceiling and florals in the Bellagio, it was time to get down to bachelor/bachelorette business.  A and M took B off to gamble, and upon the recommendation of the cabbie who picked us up from the airport (and Yelp), we headed to XS in the Encore.  (Sidebar:  The Encore (and the Wynn) have put some serious thought into unique and ornate decor and it's worth visiting both just to check it out).  This is (and probably will be) the swankiest club I've ever been to and the clientele and prices reflect it (fancy a $22 single vodka and soda and a $50 entry fee if you're a dude??)--Prince Harry was there about a week after us!  We had an awesome time celebrating C and finished off the night meeting up with the boys back at one of the bars at our hotel.

Ceiling at the Bellagio

Bellagio gardens

Inside the Encore

Enjoying Club XS

Lobby at the Bellagio!


All in all, a great trip!  If I go back to Las Vegas, A and I both agree we'd like to see the surrounding desert/natural features rather than spending the entire time on the strip; as appealing as the open drink policy is, we'd like to see the desert too!