Thursday, 1 March 2012

Pain, wedding photos, contracture and more to come

I want to start today's post by saying that I am again in a lot of pain by the end of the day when walking and actually it took a while to go away even once I was sitting down. It really was quite bad again, probably the worst that it has been since I got the orthotics, is this the end of the orthotics helping or is it just a blip as I get used to walking again after 2 weeks off for the wedding.... I am sure it is the latter otherwise I am going to be in a lot of pain for a while to come.

We also got wedding pictures and they look great and I think that it really shows on our faces what a wonderful day we had and I actually remember thinking that my foot didn't really hurt that day but what the photos are telling me is that I just pushed that to the back of my mind as in all of the photos where you can see my feet my left foot is in its classic on the side pose and this does not bother me one bit as I didn't notice it on the day you cannot see any pain on my face which is just covered with love and happiness.

One of my best men from the wedding commented on how often when he asks me how my foot is I go "eh ok" and then he reads on here that in fact I was in a lot of pain that day. Well this is because it is really bad from about 3pm onwards. Something like shown in the graph below:
 I am tempted to start doing this on a daily basis and also take into account the amount of time I am spending on my feet so that I have accurate (albeit down to my own judgement) figure on this and can actually say "well this is what happens to me". Anyway I doubt I will remember how to do it let alone actually get round to putting it all together but I will try.

So onto the main topic for today: (I do have a second one ready on paper but no time to type it up so I have a post ready for tomorrow :-)  )

I came across this: Dupuytren's disease in the feet causing flexion contractures in the toes

I have to say that this is the first time that I have seen it referred to as Dupuytren's (DD) in the feet and it does explain what it is nicely for those who have heard of Dupuytren's which is much more common than Ledderhose. In this case study from 1996 they look at two cases where they observe that contracture of the toes. This is interesting as this is considered to be very rare in Ledederhose and is a trait that is much more linked to DD. Interestingly what they mean by this is actually curling of the toes rather than the lack of flexibility like I have in my toes as shown here video toes don't move.

Some things that I got from this paper / case report were:

  • Both patients smoked - This has been linked to Ledderhose before but is not really been proven and is certainly not an issue in my case. 
  • Both have a family history of the disease which again is not an issue in my case but I am however interested in the genetics aspect of this and I am in contact with several people who have a family history and I am hoping I will be able to compile these together. If you had a black blob for a person with disease and a white blob for a family member without disease then mine would look like a load of white blobs with one black one (in case you can't guess that's me). 
  • Again they mention that LD is an uncommon manifestation as I have discussed before. They also say that it is most common in men in their 40s and 50s. 
As I said above I did come across another useful paper which is actually a review for DD and I will hopefully cover this tomorrow. 

Well I certainly hope that someone out there is finding some of my posts useful and I hope that they continue to follow and support this. I am looking forward to working my way through the book and all of the papers that I keep finding.