Recovering after Surgery #2
June 22, 2001
No, I didn't get bitten by a Komodo
Dragon... My pain started last year
when I began my 2167-mile thru-hike of Appalachian Trail and I noticed a
pain in the ball of my right foot while I hiked. It felt like I had a
pebble in my boot right under the ball of my foot. If I stopped and
stretched out my foot the pain would go away but as soon as I started
hiking again it would come back. The weight of my backpack and long
distances I was covering every day only compounded the pain. In a
few weeks it had gotten so bad that it felt like a hot poker shooting
through my foot with every single step. It took every ounce of
mental energy to hike through the pain every day. A neuroma in your foot? Well apparently so. I hobbled off the trail in
Bland, VA and two wonderful trail angels, George and Murray Ann, came to
my rescue. George insisted on taking me to a doctor. My
biggest fear was that I had a broken bone in my foot and would not be able
to continue my hike. The doctor informed me that I had a Morton's
Neuroma in between the second and third metatarsal in my right foot.
I also went to see a specialist to get a cortisone shot in the
nerve (yeah that hurt pretty bad too!). She told me that my options
were to either stop hiking or to have surgery. I said thank you
very much and went back to the trail the next day. I was not going
to abandon my hike, even if it meant being in pain every single day. Stay Focused. I am proof positive that your mind is what gets you
to Maine, not your body. The cortisone shot did nothing for the
pain, and I hiked ten 20-mile days in a row after leaving Bland, VA. The
first three days I wore my boots. On the fourth day I was in so
much pain and to top it off my feet were swelling in my boots from the
heat. I hobbled up to a shelter for a break, took off my boots in
disgust and put on my sandals to give my feet some air to breath for a few
miles. Miraculously I discovered that my foot pain was completely
gone when I hiked in sandals! For the first time in 450 miles I
walked a mile without thinking about my foot!!!! I had MY MIND
back. I could think about the trail, the beauty surrounding me, my
life, whatever I wanted! I did not have to consciously work through
the pain with every step. What is Morton's Neuroma?
Basically it is a damaged nerve in the ball of
your foot, most commonly occurring between the third and fourth
metatarsals. It is more common in women than men. It often develops
in runners and other people who tend to engage in activities where they
are pounding their feet a lot (how about hiking 2000 miles?). The
damaged nerve becomes too large for the small space in between the
metatarsals and essentially becomes "pinched" in between the bones.
Conservative measures are usually taken to try to treat the neuroma, like
changing shoes and getting cortisone shots. More severe cases
require surgery. You hiked in SANDALS??? I did what I had to do to get to Maine. It
worked great for me. I really hope this information gets to others
hikers who are suffering from this condition. All I can say is
DON'T GIVE UP! Hiking in sandals may be your solution too! I
should say that I tried every type of gel support and foot pad on the
market before switching to sandals. They did NOTHING. Anyway, I
hiked the remaining 1700 miles in the same pair of Chaco Z1 Sandals, and
that's a lot farther than the average life of a pair of boots. If
you buy them for hiking I would suggest that you buy them one size larger
than your normal shoe size - that way you have plenty of room in the front
so you don't stub your toes. Also I wore sock liners to prevent
chaffing from the straps. They dry quickly and are lightweight so I
found them to work the best. The Z1 has a vibram sole and really
good arch support. Tevas don't even compare so don't waste your
money on them. Chaco now has a new model out called the Z1 Walkabout
- it has a thicker sole with more traction. I just bought a pair so
I will let you know how they compare when I get out and about again.
You can check out Chaco's stuff on http://www.chacosandals.com/ OK now it gets gory. Beware as you scroll down because the gory foot pics
are just below. So after I finished the trail and got used to flush
toilets, ice cubes, and driving again, I decided to have the surgery to
get my neuroma removed once and for all. I would really like to be
able to attempt some bigger mountains like Rainier and you can't exactly
wear crampons with sandals or avoid frostbite with open shoes so I figured
it would be a good idea. I had my first surgery on 2/2/01. Surgery #1 I went to a so-called specialist when I got home and he did the
surgery on 2/2/01. I say "so-called" because the guy really did not
impress me with his compassion when I continued to have worse pain after
the surgery than I did before. A classic example of an egomaniac.
I could not understand why I was still having pain after 2 months
when the foot is supposed to be healed in 4-6 weeks. He told me
that reason why I was having pain was because I was out of shape.
The guy was a jerk. He got really mad and defensive at me when I got
a second opinion. How dare I question his majesty's skills. (Am I
bitter - YES!) I can tell you that my pain was real and it was worse
and I suffered horribly in the four months after that surgery. I
spent hundreds of dollars on second opinions, second second opinions,
x-rays, and even acupuncture. Here are the pictures from Surgery #1: Here are the pictures from Surgery #2:
One Day Post-Op
One Week Post-Op 
Two Weeks Post-Op
Three Weeks Post-Op
Surgery #2 So four months
later I was still in pain. The second opinions agreed that I must
have still had a piece of the neuroma in my foot. On 6/20/01 I very
reluctantly went in for a second procedure, using a different doctor than
the first time. During the first procedure I had problems with the
dissolvable stitches not dissolving so we used old fashioned stitches for
the second operation. It's much too soon to tell if this surgery was
successful yet, but I will keep you posted. I am trying to remain
optimistic, and am dreaming of the days when I can walk, run, hike, and
bike again (without pain) soon!
Pre-Op
One Week Post-Op
Two Weeks Post-Op
Three Weeks Post-Op
Results Well it's been a tough three weeks since the second surgery. I
developed an infection in the sutures last week and I thought I was going
to die! It got SO bad SO fast and before I knew it I could hardly
walk. The pain was almost unbearable. Sorry but I have no
pictures of the infection in its glory because I literally could not even
look at my foot without passing out. It was a seeping, bleeding,
swollen mess. But the antibiotics kicked in and the wound is nice and
dry again. The swelling has also gone down. (At one stage my
middle toe was as big as my big toe!) I am using magnet therapy at
night and may be going back to acupuncture next week. The nerve pain
inside my foot seems to have calmed down but is by no means totally
gone. I am not going to let this turn me into a couch potato though
so I continue to be optimistic and hope for a full recovery. Update: 10.29.02 Finally, a full update, which I've been promising all the many people
who have emailed me over the last year asking for advice with their Neuroma sagas. The response has been overwhelming. I never expected anyone to actually even look at this page, and I get more emails about my foot than other other thing on my entire site!
The good news is that I have NOT turned into a couch potato! The bad news is that I'm NOT pain-free. Actually, a few months ago, I went to a Chinese doctor in Malaysia and had acupuncture, one needle directly in the nerve (P.A.I.N.), and since then it has felt pretty good. Over a year later, I still have residual pain, BUT it is not nearly as bad as it was after surgery #1. Sometimes I have a vibration sensation/pain in the area and sometimes it just feels sore. I still have residual pain after 2 surgeries in the same spot and I feel that the pain I have now is worse than pre-surgery in the sense that I have it all the time (while sitting, while barefoot, while laying down) and before I only had it undercertain conditions (shoe dependent mostly, for me the hiking and mountaineering boots). At this stage, I can wear hiking boots for a day or two, but I still have the same pain wheen I am out hiking for 3 days or more, so after all has been said and done, I STILL hike in my Chaco sandals. Honestly knowing the hell I went through with the surgeries (because both times the incision was infected to boot), I would have to say that I regret having had the surgeries, and I wish I had simply just altered my footwear and kept the neuroma intact. I cannot, based on my personal experience, recommend this surgery to anyone. In fact, since I have had this web page up and running, I have received countless emails from people from all over the world who have been diagnosed with a Morton's Neuroma, and they have either had a failed surgery and are seeking out support from someone who can relate, or they have been recommended the surgery by their doctor and are trying to gather information in order to make the best decision for themselves.
Someday (if I ever stop travelling!) I hope to create a site dedicated to provide support and information for MN sufferers and offer a forum where people can post their own personal experiences with the surgery or whatever other treatment they have tried. That way patients can get a real sense of what their outcome may be based on what others have gone through, and people can contact each other directly to ask questions and seek advice. If you are interested in being informed about this future site to provide your story, please send me an email with a brief synopsis of your story and please include where you are from. I think it would be good to post both good and bad outcomes from the surgery, so whatever your story may be, if you are willing to share, let me know. As I said it may be awhile until I get around to it, so be patient, patients!